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Sample records for hospital based survey

  1. Understanding Patient Experience Using Internet-based Email Surveys: A Feasibility Study at Mount Sinai Hospital.

    Science.gov (United States)

    Morgan, Matthew; Lau, Davina; Jivraj, Tanaz; Principi, Tania; Dietrich, Sandra; Bell, Chaim M

    2015-01-01

    Email is becoming a widely accepted communication tool in healthcare settings. This study sought to test the feasibility of Internet-based email surveys of patient experience in the ambulatory setting. We conducted a study of email Internet-based surveys sent to patients in selected ambulatory clinics at Mount Sinai Hospital in Toronto, Canada. Our findings suggest that email links to Internet surveys are a feasible, timely and efficient method to solicit patient feedback about their experience. Further research is required to optimally leverage Internet-based email surveys as a tool to better understand the patient experience.

  2. [Current status of "hospital-clinic" and "hospital-pharmacy" cooperation for inhalation therapy -based on hospital surveys throughout Japan].

    Science.gov (United States)

    Yoshimura, Chie; Momose, Yasuyuki; Horie, Takeo; Komase, Yuko; Niimi, Akio; Dobashi, Kunio; Fujimoto, Keisaku; Tohda, Yuuji; Ohta, Ken; Adachi, Mitsuru

    2014-02-01

    The "zero death from asthma strategy" in the medical treatment for bronchial asthma has been promoted by the Ministry of Health, Labour, and Welfare from 2006, and it indicates that medical and non-medical specialists, as well as pharmacists, should cooperate, and strives to build cooperation which is suited the actual conditions of an area. It is also important for COPD. Although hospitals in some areas cooperate with clinics and pharmacies, the overall concept of cooperation appears to be absent in most Japanese hospitals. A questionnaire was administered in early March, 2012 to 477 allergology institutions, and was authorized by an educational establishment. Among 246 replies from the institutions, cooperation between hospitals and clinics was carried out by 98 institutions (39.8%) specializing in bronchial asthma, and in 64 institutions (37.2%) specializing in COPD. However, cooperation tools were used in only 37 of these institutions (15.0%). The ability to fill prescriptions outside the hospital was available in 209 institutions (85.0%). One-hundred and seventeen institutions (47.6%) replied that they have no tools for hospital-pharmacy cooperation. Direct indications were written in prescriptions by 82 institutions (33.3). In order to build inter-regional association and to equalize medical treatment, we suggest that developing tools and organization for cooperation between health professionals who treat patients with bronchial asthma and COPD is necessary.

  3. Use of simulation-based medical training in Swiss pediatric hospitals: a national survey.

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    Stocker, Martin; Laine, Kathryn; Ulmer, Francis

    2017-06-17

    Simulation-based medical training (SBMT) is a powerful tool for continuing medical education. In contrast to the Anglo-Saxon medical education community, up until recently, SBMT was scarce in continental Europe's pediatric health care education: In 2009, only 3 Swiss pediatric health care institutions used SBMT. The Swiss catalogue of objectives in Pediatrics does not acknowledge SBMT. The aim of this survey is to describe and analyze the current state of SBMT in Swiss pediatric hospitals and health care departments. A survey was carried out with medical education representatives of every institution. SBMT was defined as any kind of training with a mannequin excluding national and/or international standardized courses. The survey reference day was May 31st 2015. Thirty Swiss pediatric hospitals and health care departments answered our survey (response rate 96.8%) with 66.6% (20 out of 30) offering SBMT. Four of the 20 hospitals offering SMBT had two independently operating training simulation units, resulting in 24 educational units as the basis for our SBMT analysis. More than 90% of the educational units offering SBMT (22 out of 24 units) were conducting in-situ training and 62.5% (15 out of 24) were using high-technology mannequins. Technical skills, communication and leadership ranked among the top training priorities. All institutions catered to inter-professional participants. The vast majority conducted training that was neither embedded within a larger educational curriculum (19 out of 24: 79.2%) nor evaluated (16 out of 24: 66.6%) by its participants. Only 5 institutions (20.8%) extended their training to at least two thirds of their hospital staff. Two thirds of the Swiss pediatric hospitals and health care departments are offering SBMT. Swiss pediatric SBMT is inter-professional, mainly in-situ based, covering technical as well as non-technical skills, and often employing high-technology mannequins. The absence of a systematic approach and reaching only

  4. National Survey of Emergency Physicians Concerning Home-Based Care Options as Alternatives to Emergency Department-Based Hospital Admissions.

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    Stuck, Amy R; Crowley, Christopher; Killeen, James; Castillo, Edward M

    2017-11-01

    Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED. Specific goals included determining how often EPs ordered home-based care, what they perceive as the barriers and motivators for more extensive ordering of home-based care, and the specific conditions and response times most appropriate for such care. A group of 1200 EPs nationwide were e-mailed a six-question survey. Participant response was 57%. Of these, 55% reported ordering home-based care from the ED within the past year as an alternative to hospital admission or observation, with most doing so less than once per month. The most common barrier was an "unsafe or unstable home environment" (73%). Home-based care as a "better setting to care for low-acuity chronic or acute disease exacerbation" was the top motivator (79%). Medical conditions EPs most commonly considered for home-based care were cellulitis, urinary tract infection, diabetes, and community-acquired pneumonia. Results suggest that EPs recognize there is a benefit to providing home-based care as an alternative to hospitalization, provided they felt the home was safe and a process was in place for dispositioning the patient to this setting. Better understanding of when and why EPs use home-based care pathways from the ED may provide suggestions for ways to promote wider adoption. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  5. Diabetes mellitus, hypertension and albuminuria in rural Zambia: a hospital-based survey.

    Science.gov (United States)

    Rasmussen, Jon B; Thomsen, Jakúp A; Rossing, Peter; Parkinson, Shelagh; Christensen, Dirk L; Bygbjerg, Ib C

    2013-09-01

    To assess albuminuria in rural Zambia among patients with diabetes mellitus only (DM group), hypertension only (HTN group) and patients with combined DM and HTN (DM/HTN group). A cross-sectional survey was conducted at St. Francis Hospital in the Eastern province of Zambia. Albumin-creatinine ratio in one urine sample was used to assess albuminuria. Other information obtained included age, sex, body mass index (BMI), waist circumference (WC), blood pressure (BP), glycosylated haemoglobin (HbA1c ), random capillary glucose, time since diagnosis, medication and family history of DM or HTN. A total of 193 participants were included (DM group: n = 33; HTN group: n = 92; DM/HTN group: n = 68). The participants in the DM group used insulin more frequently as diabetes medication than the DM/HTN group (P < 0.05). Furthermore, the DM group was younger and had lower BMI, WC and BP than the two other groups. In the DM group, HTN group and DM/HTN group, microalbuminuria was found in 12.1%, 19.6% and 29.4% (P = 0.11), and macroalbuminuria was found in 0.0%, 3.3% and 13.2% (P = 0.014), respectively. The urine albumin (P = 0.014) and albumin-creatinine ratio (P = 0.0006) differed between the three groups. This hospital-based survey in rural Zambia found a lower frequency of albuminuria among the participants than in previous studies of patients with DM or HTN in urban sub-Saharan Africa. © 2013 John Wiley & Sons Ltd.

  6. Distribution of physicians and hospital beds based on Gini coefficient and Lorenz curve: A national survey

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    Satar Rezaei

    2016-06-01

    Full Text Available Introduction: Inequality is prevalent in all sectors, particularly in distribution of and access to resources in the health sector. The aim of current study was to investigate the distribution of physicians and hospital beds in Iran in 2001, 2006 and 2011. Methods: This retrospective, cross-sectional study evaluated the distribution of physicians and hospital beds in 2001, 2006 and 2011 using Gini coefficient and Lorenz curve. The required data, including the number of physicians (general practitioners and specialists, number of hospital beds and number of hospitalized patients were obtained from the statistical yearbook of Iranian Statistical Center (ISC. The data analysis was performed by DASP software. Results: The Gini Coefficients for physicians and hospital beds based on population in 2001 were 0.19 and 0.16, and based on hospitalized patients, were 0.48 and 0.37, respectively. In 2006, these values were found to be 0.18 and 0.15 based on population, and 0.21 and 0.21 based on hospitalized patients, respectively. In 2011, however, the Gini coefficients were reported to be 0.16 and 0.13 based on population, and 0.47 and 0.37 based on hospitalized patients, respectively. Although distribution status had improved in 2011compared with 2001 in terms of population and number of hospitalized patients, there was more inequality in distribution based on the number of hospitalized patients than based on population. Conclusion: This study indicated that inequality in distribution of physicians and hospital beds was declined in 2011 compared with 2001. This distribution was based on the population, so it is suggested that, in allocation of resource, the health policymakers consider such need indices as the pattern of diseases and illness-prone areas, number of inpatients, and mortality.

  7. Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.

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    Holly M Biggs

    Full Text Available The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania.We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14% of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75-102 cases per 100,000 persons annually.We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings.

  8. Estimating Leptospirosis Incidence Using Hospital-Based Surveillance and a Population-Based Health Care Utilization Survey in Tanzania

    Science.gov (United States)

    Biggs, Holly M.; Hertz, Julian T.; Munishi, O. Michael; Galloway, Renee L.; Marks, Florian; Saganda, Wilbrod; Maro, Venance P.; Crump, John A.

    2013-01-01

    Background The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. Methodology/Principal Findings We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14%) of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75–102 cases per 100,000 persons annually. Conclusions/Significance We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings. PMID:24340122

  9. A questionnaire-based survey on nurse perceptions of patient handoffs in japanese hospitals

    DEFF Research Database (Denmark)

    Gu, Xiuzhu; Itoh, Kenji; Andersen, Henning Boje

    2012-01-01

    transfer, responsibility transfer, management goals, environment and handoff system. As an overall trend, Japanese nurses indicated that both information and responsibility for the patient were transferred moderately well within the hospital. They put a higher priority on the goal of patient safety......Patient handoff is a critically important process in healthcare. However, there have been few studies investigated healthcare staff perceptions of its quality and safety. In the present paper, we seek to explore essential characteristics of patient handoff. We discuss critical factors...... and strategies contributing to effective handoffs. A questionnaire survey was conducted in 2011, collecting 1462 valid responses (74% response rate) from nurses in six Japanese hospitals. There were 17 questions, each with reply options on a five-point Likert scale, covering five main aspects: information...

  10. Clinical Characteristics of Pulmonary Tuberculosis Patients from a Southern Taiwan Hospital-based Survey

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    Chuan-Sheng Wang

    2008-01-01

    Full Text Available This study aimed to identify the clinical characteristics of culture-positive pulmonary tuberculosis (TB patients from a southern Taiwan hospital-based survey between August 1, 2003 and July 31, 2006. Demographics, symptoms, susceptibility patterns, sputum acid-fast bacilli (AFB stain status and treatment outcomes were recorded. The medical records of 154 patients who presented to the Kaohsiung Municipal Hsiao-Kang Hospital were analyzed retrospectively. The mean age of patients was 59.5 years; 115 patients were male and 39 were female. Diabetes mellitus (48/154; 31.2% was the most frequent risk factor for pulmonary TB infection. Nearly all patients (139/154; 90.3% had a cough. Fever was only seen in 27.9% and hemoptysis in 14.9% of patients. The combined resistance rates of Mycobacterium tuberculosis to the tested first-line agents were as follows: isoniazid, 3.2%; rifampin, 7.8%; ethambutol, 5.8%; and streptomycin, 2.6%. The combined resistance rate to any one of four first-line drugs was 12.3%. The combined resistance rate to ofloxacin was 3.9%. The combined resistance rate of multidrug resistant-TB was 1.9%. Sputum AFB stains were positive in 68.2% of cases. Analysis of treatment outcomes showed overall treatment success at 76.6%. The proportions of patients who died, defaulted treatment or in whom treatment failed were 16.2%, 3.9% and 0.0%, respectively. In conclusion, our study showed: (1 a higher frequency of pulmonary TB in male subjects than in other areas of Taiwan; (2 a higher frequency of cough and lower frequency of fever and hemoptysis than previous studies; (3 that the combined resistance rates to isoniazid and streptomycin were lower than both average levels in Taiwan and the global combined drug resistance rate; and (4 a higher proportion of patients responding to treatment and lower proportions of patients suffering mortality, defaulting treatment or not responding to treatment compared with other areas of Taiwan. With regard

  11. Survey alerts hospital to needs of consumers.

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    Schoenfeldt, R C; Seale, W B; Hale, A W

    1987-09-01

    Because of rapidly changing developments in the healthcare field, more emphasis is being placed on marketing of hospital services. A hospital's success will depend more and more on strategic planning based on timely and accurate information. In light of this, Lourdes Hospital, Paducah, KY, undertook a survey to evaluate its current performance and to determine a path for the future. The survey found, among other discoveries, that patients want more voice in determining their own treatment; they prefer outpatient treatment when possible, even if it is not covered by insurance; and stress management and health assessment clinics are the most popular extra services a hospital could offer. Physicians surveyed said they wanted more input into the evaluation of new services and equipment at the hospital. The survey also found that most patients either select a hospital in conjunction with their physician or have their physician choose the hospital. The findings led to some major changes at the hospital, including a restructuring of the planning process to get physicians more involved, a new marketing strategy to enhance communication with consumers, and increased outpatient services. The results have given direction to the hospital administration, helped shape advertising, and provided support for certificate-of-need requests.

  12. Prospective hospital-based survey of attitudes of Southern women toward surgical treatment of breast cancer.

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    Wei, J P; Sherry, R M; Baisden, B L; Peckel, J; Lala, G

    1995-07-01

    Breast-conserving surgery is equivalent to total mastectomy in the treatment of breast cancer. The Southern part of the United States has a low rate of breast conservation. We surveyed 300 women: 100 hospital personnel, 100 cancer clinic patients, and 100 non-cancer clinic patients. The women were asked about their attitudes toward breast cancer, surgery preferences, and factors that might influence their decisions. One hundred eighty-nine chose mastectomy as the best operation, 106 women chose lumpectomy, and five women were undecided. There was no difference in mean age, racial distribution, education level, income level, percentage of women who considered themselves Southern women, concerns about breast cancer, recent mammograms, previous breast surgery, previous breast cancer treatment, or acquaintances with breast cancer between the mastectomy and the lumpectomy groups. Women interested in saving the breast were more likely to pick lumpectomy (35 vs. 84%, p = 0.001). A fear of cancer recurrence played a role in the decision (88 vs. 40%, p = 0.001). Fear of radiation therapy (76 vs. 57%, p = 0.002) and of the side effects (80 vs. 63%, p = 0.005) was a significant factor. The choice of surgery for breast cancer is an individual process between a woman and her surgeon. Attitudes and fears regarding cancer recurrence and radiation therapy may make women select mastectomy over lumpectomy.

  13. A hospital-based survey of patients with severe valvular heart disease in China.

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    Hu, Po; Liu, Xian-Bao; Liang, Jie; Zhu, Qi-Feng; Pu, Chao-Xia; Tang, Meng-Yao; Wang, Jian-An

    2017-03-15

    Due to increasing aging, the epidemiology of VHD may have changed in China. This study aimed to provide contemporary information on the prevalence, distribution patterns, and etiology of severe VHD in China. This was a retrospective survey at Second Affiliated Hospital of Zhejiang University, which included all consecutive patients between 2010 and 2015. In all, 139,496 patients were enrolled. Among severe valve diseases, MR was the most frequent (n=946, 0.68%) followed by MS (n=524, 0.38%), AS (n=392, 0.28%), and AR (n=371, 0.27%). Severe MR and AS prevalence rates increased strikingly with age. Rheumatic heart disease had an prevalence of 1.56% (n=2179), and remained one of the most common causes of severe VHD in patients younger than 65years old (99.5% of MS with rheumatic; 27.6% of MR with rheumatic; 25.7% of AS with rheumatic; 31.6% of AR with rheumatic). Aortic valve calcification was the predominant AS etiology, and its prevalence greatly increased with age. In severe AR, rheumatic fever was the most common etiology in patients below 65; in those above 65, etiology was mostly degenerative. In severe primary MR, mitral valve prolapse was the most common cause. Prevalence of secondary MR increased with age, from 16.4% in 18-44years old to 51.7% in individuals ≥75. Severe valvular diseases are very common; rheumatic fever and degenerative valvular changes remain predominant causes in patients below 65 and older ones, respectively. Young adults present mainly with primary MR, while secondary MR is more common in elderly ones. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital - Hospital

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    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  15. Incidence of hospital referred head injuries in Norway: a population based survey from the Stavanger region

    DEFF Research Database (Denmark)

    Heskestad, Ben; Baardsen, Roald; Helseth, Eirik

    2009-01-01

    it with previous Norwegian studies. METHODS: All head injured patients referred to Stavanger University Hospital during a one-year period (2003) were registered in a partly prospective and partly retrospective study. The catchment area for the hospital is strictly defined to a local population of 283...

  16. Public acceptance of a hypothetical Ebola virus vaccine in Aceh, Indonesia: A hospital-based survey

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    Harapan Harapan

    2017-04-01

    Full Text Available Objective: To determine the acceptance towards a hypothetical Ebola virus vaccine (EVV and associated factors in a non-affected country, Indonesia. Methods: A hospital-based, cross-sectional study was conducted in four regencies of Aceh, Indonesia. A set of pre-tested questionnaires was used to obtain information on acceptance towards EVV and a range of explanatory variables. Associations between EVV acceptance and explanatory variables were tested using multi-steps logistic regression analysis and the Spearman's rank correlation. Results: Participants who had knowledge on Ebola virus disease (EVD were 45.3% (192/424 and none of the participants achieved 80% correct answers on the knowledge regarding to EVD. About 73% of participants expressed their willingness to receive the EVV. Education attainment, occupation, monthly income, have heard regarding to EVD previously, socioeconomic level, attitude towards vaccination practice and knowledge regarding to EVD were associated significantly with acceptance towards EVV in univariate analysis (P < 0.05. In the final multivariate model, socio-economic level, attitude towards vaccination practice and knowledge regarding to EVD were the independent explanatory variables for EVV acceptance. Conclusions: The knowledge of EVD was low, but this minimally affected the acceptance towards EVV. However, to facilitate optimal uptake of EVV, dissemination of vaccine-related information prior to its introduction is required.

  17. Hypertension and Diabetes Self-care Activities: A Hospital Based Pilot Survey in Benin City, Nigeria.

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    Egbi, O G; Ofili, A N; Oviasu, E

    2015-06-01

    The burden of hypertension and diabetes is on the increase globally with its attendant complications. Although self-care activities are critical to the successful management of both conditions, there are only a few reports on such activities, especially in this part of the world. This pilot study was therefore undertaken to assess the self-care activities among hypertensive and diabetic patients in Benin City. Hypertensive and diabetic patients were consecutively recruited from the out- patient department of the University of Benin Teaching Hospital. The questionnaires were developed based on past assessment scales such as the Hypertension Self-Care Activity Level Effects (H-SCALE) and the Summary of Diabetes Self-Care Assessment (SDSCA) for hypertensive and diabetic participants respectively. A total of 85(32 hypertensive, 24 diabetic and 29 co-morbid hypertensive diabetic) participants completed the study. Only 14 (16.5%) subjects had good self-care practice, 39 (45.9%) had fair practice while poor self-care practice was found in 32 (37.6%) subjects. Adherence to medications, clinic adherence, use of self-monitoring devices, regular exercising and dietician contact were generally low. However, only a relatively few subjects smoked tobacco or took significant alcohol. The health-related self-care practice among the patients was generally not good. There was no significant difference in the overall level of self-care among hypertensive, diabetic patients or those with co-morbid conditions. There is need for more aggressive health education aimed at improving the current health-related self-care habits among these patients.

  18. Incidence Rate of Community-Acquired Sepsis Among Hospitalized Acute Medical Patients-A Population-Based Survey

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Laursen, Christian B; Jensen, Thøger Gorm

    2015-01-01

    to the hospital. DESIGN:: Population-based survey. SETTING:: Medical emergency department from September 1, 2010, to August 31, 2011. PATIENTS:: All patients were manually reviewed using a structured protocol in order to identify the presence of infection. Vital signs and laboratory values were collected...... to define the presence of systemic inflammatory response syndrome and organ dysfunction. MEASUREMENTS AND MAIN RESULTS:: Incidence rate of sepsis of any severity. Among 8,358 admissions to the medical emergency department, 1,713 patients presented with an incident admission of sepsis of any severity, median...... on symptoms and clinical findings at arrival, incidence rates of patients admitted to a medical emergency department with sepsis and severe sepsis are more frequent than previously reported based on discharge diagnoses....

  19. Determinants of abortions in Katete District of Zambia: A hospital based survey

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    Cibangu Katamba

    2015-01-01

    Full Text Available This research was conducted at Saint Francis at Saint Francis Hospital over a period of four months (from September 22nd 2014 to January 23rd 2015. 168 women aged 12 to 46 years admitted and treated for incomplete abortion in Gynecology ward were interviewed. 63 participants (37.5% had induced abortions and 105 participants (62.5% had spontaneous abortions. All induced abortions were the results of unplanned pregnancies. The majority of all abortions (57.1% resulted from unplanned pregnancies as compared to only 42.9% resulting from planned pregnancies (p<0.05. Both married and single participants had increased unmet needs for family planning. 57.3% of women had used contraceptives in the past and also had unintended pregnancies resulting in abortions. A significant number of induced abortions (22.2% were incidentally caused by inappropriate use of contraceptives by providers. Sexual activities start as early as 9 years in Katete. Most youths with induced abortions were involved in unstable relationships, desired to continue with education, feared to ruin their future, and had limited knowledge and inconsistent use of contraceptive methods. The major determinants for induced abortions amongst participants were unplanned/unintended pregnancies. Other determinants such as illiteracy, lack of information, young age, poverty, and unsafe sex need to be addressed. There is need to promote consistent and correct use of contraceptives, to strengthen the health care delivery system and maintain the cold chain of contraceptive supply for sustainable availability and accessibility. Conjugated efforts by health care providers, community leaders, policy makers and politicians are needed to extirpate negative believes (on modern contraceptives and cultural norms that promote unhealthy sexual and reproductive life.

  20. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

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    Mohan Roy Gopalan

    2016-01-01

    Full Text Available Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above, having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7% had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6% of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

  1. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

    Science.gov (United States)

    Gopalan, Mohan Roy; Karunakaran, Vidhukumar; Prabhakaran, Anil; Jayakumar, Krishnannair Lalithamma

    2016-01-01

    Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients. PMID:28066004

  2. National Hospital Ambulatory Medical Care Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...

  3. A Novel Service-Oriented Professional Development Program for Research Assistants at an Academic Hospital: A Web-Based Survey.

    Science.gov (United States)

    Kitts, Robert Li; Koleoglou, Kyle John; Holland, Jennifer Elysia; Hutchinson, Eliza Haapaniemi; Nang, Quincy Georgdie; Mehta, Clare Marie; Tran, Chau Minh; Fishman, Laurie Newman

    2015-11-02

    Research assistants (RAs) are hired at academic centers to staff the research and quality improvement projects that advance evidence-based medical practice. Considered a transient population, these young professionals may view their positions as stepping-stones along their path to graduate programs in medicine or public health. To address the needs of these future health professionals, a novel program-Program for Research Assistant Development and Achievement (PRADA)-was developed to facilitate the development of desirable professional skill sets (ie, leadership, teamwork, communication) through participation in peer-driven service and advocacy initiatives directed toward the hospital and surrounding communities. The authors hope that by reporting on the low-cost benefits of the program that other institutions might consider the utility of implementing such a program and recognize the importance of acknowledging the professional needs of the next generation of health care professionals. In 2011, an anonymous, Web-based satisfaction survey was distributed to the program membership through a pre-established email distribution list. The survey was used to evaluate demographics, level of participation and satisfaction with the various programming, career trajectory, and whether the program's goals were being met. Upon the completion of the survey cycle, a 69.8% (125/179) response rate was achieved with the majority of respondents (94/119, 79.0%) reporting their 3-year goal to be in medical school (52/119, 43.7%) or nonmedical graduate school (42/119, 35.3%). Additionally, most respondents agreed or strongly agreed that PRADA had made them feel more a part of a research community (88/117, 75.2%), enhanced their job satisfaction (66/118, 55.9%), and provided career guidance (63/117, 53.8%). Overall, 85.6% of respondents (101/118) agreed or strongly agreed with recommending PRADA to other research assistants. High response rate and favorable outlook among respondents

  4. A hospital-based survey of primary hyperparathyroidism in the AsirRegion: Low prevalence or underdiagnosis

    International Nuclear Information System (INIS)

    Al-Shehri, Mohammed Y.

    1999-01-01

    The number of patients with primary hyperparathyroidism (PHP) seen at theAsir Central Hospital (ACH) is remarkably low. This observation has raisedthe question of whether there is a low prevalence of PHP in the Asir region,whether it is underdiagnosed, or perhaps a combination of other both factors.A survey of 15 hospitals in the Asir region was conducted for the cases ofPHP. All case notes of the patients with PHP are seen at ACH were reviewed.Also a sample of patients seen at ACH was chosen randomly. The charts ofthose found to have hypercalcemia were reviewed for the inclusion of PHP inthe diagnostic work-up. Only 13 patients with PHP were discovered. The eightpatients with PHP seen at ACH had advanced bone manifestations and seven ofthem had renal manifestations. Hypercalcemia was found in 39 out of 655patients seen at ACH. None of these had been investigated for PHP. The numberof patients with PHP seen in hospitals in the Asir region is very low.Underdiagnosis seems to be an important factor. Therefore, it is felt thatthere is a need for greater awareness of disease in the region. Furthermore,there is a need for national survey to measure the prevalence of PHP in SaudiArabia. (author)

  5. Hospital doctors' self-rated skills in and use of evidence-based medicine - a questionnaire survey

    DEFF Research Database (Denmark)

    Oliveri, Roberto S; Gluud, Christian; Wille-Jørgensen, Peer A

    2004-01-01

    Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM...

  6. Survey of Canadian hospitals radiation emergency plans

    Energy Technology Data Exchange (ETDEWEB)

    Davis, C [Social Data Research Ltd./The Flett Consulting Group, Inc., Ottawa, ON (Canada)

    1996-02-01

    This report documents the findings of a survey of Canadian hospitals conducted by Social Data Research Ltd. during the Spring and Summer, 1995. The main objective of the survey was to determine the state of readiness of Canadian hospitals in respect of radiation emergency planning. In addition, the AECB was interested in knowing the extent to which a report by the Group of Medical Advisors, `GMA-3: Guidelines on Hospital Emergency Plans for the Management of Minor Radiation Accidents`, which was sponsored and distributed in 1993, was received and was useful to hospital administrators and emergency personnel. A self-administered questionnaire was distributed to 598 acute care hospitals, and 274 responses were received. The main conclusion of this study is that, with the exception of a few large institutions, hospitals generally do not have specific action plans to handle minor radiation accidents. (author).

  7. Survey of Canadian hospitals radiation emergency plans

    International Nuclear Information System (INIS)

    Davis, C.

    1996-02-01

    This report documents the findings of a survey of Canadian hospitals conducted by Social Data Research Ltd. during the Spring and Summer, 1995. The main objective of the survey was to determine the state of readiness of Canadian hospitals in respect of radiation emergency planning. In addition, the AECB was interested in knowing the extent to which a report by the Group of Medical Advisors, 'GMA-3: Guidelines on Hospital Emergency Plans for the Management of Minor Radiation Accidents', which was sponsored and distributed in 1993, was received and was useful to hospital administrators and emergency personnel. A self-administered questionnaire was distributed to 598 acute care hospitals, and 274 responses were received. The main conclusion of this study is that, with the exception of a few large institutions, hospitals generally do not have specific action plans to handle minor radiation accidents. (author)

  8. Prevalence of HTLV-1/2 infections in Spain: A cross-sectional hospital-based survey.

    Science.gov (United States)

    Treviño, Ana; García, Juan; de Mendoza, Carmen; Benito, Rafael; Aguilera, Antonio; Ortíz de Lejarazu, Raul; Ramos, José M; Trigo, Matilde; Eirós, Jose M; Rodríguez-Iglesias, Manuel; Torres, Alvaro; Calderón, Enrique; Hernandez, Araceli; Gomez, Cesar; Marcaida, Goizane; Soriano, Vincent

    2010-08-01

    The presence of antibodies to human T-lymphotropic virus (HTLV) types 1 and 2 was examined in 5742 sera belonging to consecutive adult outpatients attended during June 2008 at 13 different hospitals across Spain. Overall, 58.8% were female. Foreigners represented 8% of the study population. Seven individuals were seropositive for HTLV-2 (overall prevalence 0.12%). No cases of HTLV-1 infection were found. All HTLV-2(+) subjects were Spanish natives, of whom six were coinfected with HIV-1 and five with hepatitis C virus (HCV). Moreover, all but one of the HTLV-2(+) subjects had been intravenous drug users. In summary, this cross-sectional survey suggests that the rate of HTLV infection in Spain is low, and is mostly represented by HTLV-2. Infected individuals are generally Spanish natives with a prior history of intravenous drug use and are coinfected with HIV-1 and/or HCV.

  9. Hospital safety climate surveys: measurement issues.

    Science.gov (United States)

    Jackson, Jeanette; Sarac, Cakil; Flin, Rhona

    2010-12-01

    Organizational safety culture relates to behavioural norms in the workplace and is usually assessed by safety climate surveys. These can be a diagnostic indicator on the state of safety in a hospital. This review examines recent studies using staff surveys of hospital safety climate, focussing on measurement issues. Four questionnaires (hospital survey on patient safety culture, safety attitudes questionnaire, patient safety climate in healthcare organizations, hospital safety climate scale), with acceptable psychometric properties, are now applied across countries and clinical settings. Comparisons for benchmarking must be made with caution in case of questionnaire modifications. Increasing attention is being paid to the unit and hospital level wherein distinct cultures may be located, as well as to associated measurement and study design issues. Predictive validity of safety climate is tested against safety behaviours/outcomes, with some relationships reported, although effects may be specific to professional groups/units. Few studies test the role of intervening variables that could influence the effect of climate on outcomes. Hospital climate studies are becoming a key component of healthcare safety management systems. Large datasets have established more reliable instruments that allow a more focussed investigation of the role of culture in the improvement and maintenance of staff's safety perceptions within units, as well as within hospitals.

  10. Different utilization of intensive care services (ICSs) for patients dying of hemorrhagic and ischemic stroke, a hospital-based survey.

    Science.gov (United States)

    Wang, Vinchi; Hsieh, Chieh-Chao; Huang, Yen-Ling; Chen, Chia-Ping; Hsieh, Yi-Ting; Chao, Tzu-Hao

    2018-02-01

    The intensive care service (ICS) saves lives and rescues the neurological function of stroke patients. We wondered the different utilization of ICS for patients with ischemic and hemorrhagic stroke, especially those who died within 30 days after stroke.Sixty-seven patients died during 2011 to 2015 due to acute stroke (42 due to intracranial hemorrhage [ICH]; 25 due to cerebral infarct [CI]). The durations of hospital stay (hospital staying days [HSDs]) and ICS staying days (ISDs) and codes of the do-not-resuscitate (DNR) were surveyed among these medical records. Statistics included chi-square and descriptive analyses.In this study, CI patients had a longer HSD (mean 14.3 days), as compared with ICH patients (mean 8.3 days); however, the ICH patients had a higher percentage of early entry within the first 24 hours of admission into ICS than CI group (95.1% vs 60.0%, P = .003). A higher rate of CI patients died in holidays or weekends than those with ICH (44.0% vs 21.4%, P = .051). DNR, requested mainly from direct descendants (children or grandchildren), was coded in all 25 CI patients (100.0%) and 38 ICH patients (90.5%). More cases with early DNR coded within 24 hours after admission occurred in ICH group (47%, 12% in CI patients, P = .003). None of the stroke patient had living wills. Withhold of endotracheal intubation (ETI) occurred among CI patients, more than for ICH patients (76.0% vs 18.4%, P mortality within holidays or weekends, and higher ETI withhold; but less percentage of ICS utilization expressed by a lower ISD/HSD ratio. This ICS utilization is a key issue of medical quality for stroke care.

  11. A survey report: how hospitals measure liquidity.

    Science.gov (United States)

    Cleverley, W O; Massar, G S

    1983-11-01

    Liquidity is an important financial concept that is widely understood although not authoritatively defined. In many situations the actual assessment of liquidity is based on the relationship of current assets and current liabilities. Nationally, a decline in traditional measures of liquidity such as current and quick ratios has occurred for both general industry and the hospital industry. There are a variety of possible explanations for this trend, but one of special interest in this article was the effect of financial reporting practices. A recent Principles & Practices Board survey of Financial Analysis Service subscribers indicated that there is a potential for underreporting working capital, (current assets less current liabilities), in the hospital industry. However, this does not necessarily imply that the recent decline in liquidity measures is in any way due to reporting practices. No information about changes in reporting practices was obtained in this study. Finally, the results of the study do suggest that examination of more than one liquidity indicator is useful. Specifically, restricting attention to just the current ratio could be misleading. In this vein, it is interesting to note that six measures of liquidity are used in the FAS. All may provide insight into an accurate assessment of liquidity.

  12. Estimating costs of pressure area management based on a survey of ulcer care in one Irish hospital.

    Science.gov (United States)

    Gethin, G; Jordan-O'Brien, J; Moore, Z

    2005-04-01

    Pressure ulceration remains a significant cause of morbidity for patients and has a real economic impact on the health sector. Studies to date have estimated the cost of management but have not always given a breakdown of how these figures were calculated. There are no published studies that have estimated the cost of management of pressure ulcers in Ireland. A two-part study was therefore undertaken. Part one determined the prevalence of pressure ulcers in a 626-bed Irish acute hospital. Part two set out to derive a best estimate of the cost of managing pressure ulcers in Ireland. The European Pressure UlcerAdvisory Panel (EPUAP) minimum data set tool was used to complete the prevalence survey. Tissue viability nurses trained in the data-collection tool collected the data. A cost was obtained for all items of care for the management of one patient with three grade IV pressure ulcers over a five-month period. Of the patients, 2.5% had pressure ulcers. It cost Euros 119,000 to successfully treat one patient. We estimate that it costs Euros 250,000,000 per annum to manage pressure ulcers across all care settings in Ireland.

  13. Hospital network performance: a survey of hospital stakeholders' perspectives.

    Science.gov (United States)

    Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P

    2013-02-01

    Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Psychometric Evaluation of the Hospital Culture of Transitions Survey.

    Science.gov (United States)

    McClelland, Mark; Bena, James; Albert, Nancy M; Pines, Jesse M

    2017-10-01

    Ineffective or inefficient transitions threaten patient safety, hinder communication, and worsen patient outcomes. The Hospital Culture of Transitions (H-CulT) survey was designed to assess a hospital's organizational culture related to within-hospital transitions in care involving patient movement. In this article, psychometric properties of the H-CulT survey were examined to assess and refine the hospital culture of transitions. A cross-sectional, multicenter, multidisciplinary correlational design and survey methods were used to examine the psychometric properties of the H-CulT survey. Exploratory factor analysis was used to quantify the accuracy of the previously identified structure. Specifically, the analysis involved the principal axis factor method with an oblique rotation, based on a polychoric correlation matrix. A sample of 492 respondents from 13 diverse hospitals participated. Cronbach's alpha for the instrument was 0.88, indicating strong internal consistency. Seven subscales emerged and were labeled: Hospital Leadership, Unit Leadership, My Unit's Culture, Other Units' Culture, Busy Workload, Priority of Patient Care, and Use of Data. Correlations between subscales ranged from 0.07 to 0.52, providing evidence that the subscales did not measure the same construct. Subscale correlations with the total score were near or above 0.50 (p <0.001). Use of a factor-loading cutoff of 0.40 resulted in the elimination of 12 items because of weak associations with the topic. The H-CulT is a psychometrically sound and practical survey for assessing hospital culture related to patient flow during transitions in care. Survey results may prompt quality improvement interventions that enhance in-hospital transitions and improve staff satisfaction and patient satisfaction with care. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  15. Patient-centeredness and e-health among Italian hospitals: results of a cross-sectional web-based survey.

    Science.gov (United States)

    De Feo, Emma; de Belvis, Antonio Giulio; Silenzi, Andrea; Specchia, Maria Lucia; Gallì, Paoloa; Ricciardi, Walter

    2012-12-01

    Given the growing recognition of patient-centeredness as a healthcare quality indicator and its limited implementation in practice, our study evaluated how the Italian hospitals (ItHs), including research hospitals (IRCCSs), research teaching hospitals (THs), and independent public hospital trusts (AOs), address the dimension of online data access through their institutional Web sites to promote a patient-centered care. To address patient-centeredness and e-health, eight specific indicators adapted from the Euro Health Consumer Index were evaluated from 169 ItHs: online booking of healthcare services; access to medical records; register of legitimate doctors; waiting times for most commonly delivered healthcare services; transport information; centralized booking; public relations office; and pain management hospital committee. Univariate and bivariate statistics and a logistic regression analysis have been performed. The majority of the ItHs were under public ownership, and half of them are located in Northern Italy. From the logistic regression analysis, AOs appeared to be more likely to develop a patient-centered healthcare approach (odds ratio [OR]=3.69; 95% confidence interval [CI] 1.14-11.89) compared with IRCCSs or THs. In addition, when grouped together, all public hospitals show more than threefold higher implementation of patient-centeredness strategies (OR=3.60; 95% CI 1.49-8.72) with respect to private ones. Northern hospitals are more likely to ensure wider implementation of a patient-centered approach to healthcare (OR=3.37; 95% CI 1.49-7.62). According to our results, most of the ItHs are under public ownership, and half of them are located in the northern regions of Italy. The higher implementation of patient-centeredness strategies observed for Northern hospitals highlights interregional disparity in healthcare that needs a coordinated effort at both the hospital and policymaker levels to ensure a widespread implementation of patient-centered care

  16. Prevalence of hypertension and its risk factors in southwest Ethiopia: a hospital-based cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Gudina EK

    2013-07-01

    Full Text Available Esayas Kebede Gudina,1 Yadani Michael,1 Sahilu Assegid2 1Department of Internal Medicine, Jimma University, Jimma, Ethiopia; 2Department of Epidemiology, Jimma University, Jimma, Ethiopia Background: Hypertension is a common medical condition worldwide. It is an important public health challenge because of the associated morbidity, mortality, and the cost to the society. The objective of this study was to determine the prevalence of hypertension and its risk factors among attendants of adult outpatient departments at Jimma University Specialized Hospital in southwest Ethiopia. Materials and methods: A hospital-based cross-sectional study was conducted on 734 participants aged 15 years or older from May 2012 to June 2012. A pretested structured questionnaire consisting of characteristics related to sociodemographic profiles and risk factors for hypertension was used for data collection. Three separate measurements of blood pressure and relevant anthropometric evaluation were taken according to current recommended standards. Chi-square test and other statistical analyses were done to employ appropriate interpretations of the findings. P-values of <0.05 were considered statistically significant. Results: The mean age of the participants was 42.3 ± 13.2 years and 71.7% of them were 35 years and older; 58% of them were females. Overall prevalence of hypertension – defined by systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 or reporting history of hypertension – was found to be 13.2%. Only 35.1% of them were aware of their hypertension and only 23.7% were on treatment. The overall control rate was 15.5%. Family history of hypertension, having diabetes mellitus, being overweight, and oral contraceptive use were associated with high blood pressure. Conclusion: Hypertension was found to be prevalent; morbidity, awareness, treatment, and control in those with hypertension were low. Hence, intervention measures should be undertaken

  17. Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey

    Directory of Open Access Journals (Sweden)

    Ann Versporten, MPH

    2018-06-01

    Full Text Available Summary: Background: The Global Point Prevalence Survey (Global-PPS established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. Methods: We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015. Hospitals were classified as primary, secondary, tertiary (including infectious diseases hospitals, and paediatric hospitals. Five main ward types were defined: medical wards, surgical wards, intensive-care units, haematology oncology wards, and medical transplantation (bone marrow or solid transplants wards. Data recorded included patient characteristics, antimicrobials received, diagnosis, therapeutic indication according to predefined lists, and markers of prescribing quality (eg, whether a stop or review date were recorded, and whether local prescribing guidelines existed and were adhered to. We report findings for adult inpatients. Findings: The Global-PPS for 2015 included adult data from 303 hospitals in 53 countries, including eight lower-middle-income and 17 upper-middle-income countries. 86 776 inpatients were admitted to 3315 adult wards, of whom 29 891 (34·4% received at least one antimicrobial. 41 213 antimicrobial prescriptions were issued, of which 36 792 (89·3% were antibacterial agents for systemic use. The top three antibiotics prescribed worldwide were penicillins with β-lactamase inhibitors, third-generation cephalosporins, and fluoroquinolones. Carbapenems were most frequently prescribed in Latin America and west and central Asia. Of patients who received at least one antimicrobial

  18. Assessment of healthcare personnel knowledge of stroke care at a large referral hospital in sub-Saharan Africa - A survey based approach.

    Science.gov (United States)

    Lin, Chen; Vakani, Ravi; Kussin, Peter; Guhwe, Mary; Farjat, Alfredo E; Choudhury, Kingshuk; Renner, David; Oduor, Chrispine; Graffagnino, Carmelo

    2017-08-01

    There is no published literature regarding sub-Saharan health-care providers' understanding of stroke management patterns. Understanding current stroke management knowledge is important in formulating future education opportunities for providers to optimize patient outcomes. A cross-sectional survey of acute stroke diagnosis, hospital management, and secondary prevention questions was administered to health-care providers working in one large Kenyan acute referral hospital. Due to the prevalence of medical students (61.8%), an experienced-focused analysis contrasted students with more experienced providers. Providers (n=199) anonymously responded to the surveys. Among the acute diagnosis most respondents stated that stroke scales should always used (58.3% of respondents), 3h was the time period for alteplase (t-PA) (53.8% of respondents), and CT scan should be always be obtained prior to administration of anticoagulant therapy (61.3% of respondents). Neither VTE prophylaxis nor dysphagia/swallowing screening were considered to be done a majority of time. Secondary prevention results were variable. The respondent's level of clinical experience made the most difference in correctly answering the most appropriate IV Fluid to use in stroke patients (adjusted p=0.003) and the ideal initiation time for antithrombotic therapy (adjusted p=0.0017). Healthcare providers demonstrated a wide variability in their responses. Future efforts to improve stroke care in sub-Saharan Africa should include education and process improvement initiatives to focus on more specific aspects of stroke management based on the results from this survey. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. [Patient endangerment due to device diversity? : Discussion of a risk factor based on the results of two surveys of German hospitals].

    Science.gov (United States)

    Lange, K; Brinker, A; Nowak, M; Zöllner, C; Lauer, W

    2018-05-25

    The Federal Institute for Drugs and Medical Devices (BfArM) was notified of an event in which it was not possible to sufficiently ventilate a patient suffering a severe asthma attack. It turned out that the ventilation pressures used by the device for pressure-controlled ventilation were below the values set by the user, which the user was not aware of. The ventilation pressures chosen by the user exceeded the preset alarm limits of the ventilator. This pressure and alarm management significantly differed from that of other ventilators used in the hospital. This and similar incident reports suggest that safely operating medical devices for anesthesia and intensive care may be impaired when different models of a device are used within a hospital. If different models are used, more device information needs to be stored in memory. Existing knowledge on human memory suggests that the more individual memory items (e. g. different operating rules) are stored, the greater the risk of memory interference and hence of impaired retrieval, particularly if the different items are associated with overlapping retrieval cues. This is the case when different devices are used for a single functional purpose under identical or similar circumstances. Based on individual incident reports and theoretical knowledge on an association between device diversity and use problems, this study aimed to determine the organizational conditions regarding device diversity that prevail in German hospitals. Additionally, the anesthetists' perspectives and experiences in defined clinical settings were investigated. For selected groups of medical devices, the biomedical engineers of German hospitals were surveyed about the different makes used in their hospital. Additionally, questionnaires were sent to a department of anesthesiology of a large University Hospital to investigate the personal experiences of working with different makes and models of a device. Using devices by different

  20. Radon Survey in Hospitals in Slovenia

    International Nuclear Information System (INIS)

    Vaupotic, J.

    2003-01-01

    In Slovenia, several radon studies at workplaces have been carried out in last years, supported by the Ministry of Education, Science and Sport, and the Ministry of Health. After radon surveys in kindergartens, schools and homes, within which about 2600 buildings were checked for radon and which provided the level of radon problem in the country, next investigations were focused on the workplaces with potentially higher radon risk. Hence, in the Postojna Cave permanent radon monitoring was introduced in 1995 and comprehensive radon studies were performed: in 5 bigger spas during 1996-1998, in major waterworks and wine cellars in 2001, and in major Slovene hospitals in 2002. This paper reports the results of radon study in 26 major Slovene hospitals, comprising radon concentrations in 201 rooms and dose estimates for 1025 persons working in these rooms. Radon survey in 201 rooms of 26 major hospitals in Slovenia revealed only 7 rooms in which monthly average radon concentration in the indoor air exceeded 400 Bqm -3 . Generally, concentrations in basement were on average for about 30% higher than in ground floor, although exceptionally high values have also been found in the ground floor. For 966 persons (94.2%) of the total of 1025 persons working in the rooms surveyed, the annual effective dose, estimated according to the Basic Safety Standards was below 1 mSv, while for 59 it exceeded 1 mSv. In 7 rooms with more than 400 Bqm -3 in which 16 persons receive between 2.1 and 7.3 mSv per year radon monitoring is continued. (author)

  1. A retrospective survey of human hydatidosis based on hospital records during the period 1990-2003 in Ngorongoro, Tanzania.

    Science.gov (United States)

    Ernest, E; Nonga, H E; Kynsieri, N; Cleaveland, S

    2010-12-01

    A 13-year (1990-2003) retrospective study was carried out to investigate the occurrence of cystic echinococcosis (CE) in patients at Wasso hospital in Ngorongoro district, Tanzania. Hospitalization records were reviewed and confirmed cases of CE were classified according to ward of residence, age, sex, cyst location and type. A total of 171 hydatidosis patients were diagnosed and operated giving an average of 13 cases per year, equivalent to approximately 10 cases per 100,000 people per year. Cystic echinococcosis affected more females (59.1%) than males (40.9%). A significantly higher number of CE cases were recorded in individuals 30 years of age (2.3-9.4%) (P Ngorongoro district and female and youths are those most affected. These findings merit for more extensive epidemiological investigations of CE in human to better determine the prevalence, economic impact and risk factors for the disease in this district and other areas of Tanzania. © 2009 Blackwell Verlag GmbH.

  2. Attitudes and practices of Chinese physicians regarding chronic kidney disease and acute kidney injury management: a questionnaire-based cross-sectional survey in secondary and tertiary hospitals.

    Science.gov (United States)

    Wu, Yanhua; Chen, Yuanhan; Chen, Shixin; He, Yani; Liang, Huaban; Dong, Wei; Liang, Xinling

    2018-05-10

    This questionnaire-based cross-sectional survey reported the attitudes and practices of Chinese doctors regarding chronic kidney disease (CKD) and acute kidney injury (AKI) management. An online questionnaire consisting of general information, awareness of CKD and AKI, education status, renal laboratory items, and clinical practices between February 20, 2017 and August 15, 2017. Among the 1289 respondents from secondary and tertiary hospitals in 30 provinces, 718 (55.7%) were nephrologists, 94.3% had the ability to evaluate glomerular filtration rates, and 98.8% could evaluate urinary protein excretion, indicating that Chinese doctors met the minimum requirements to manage CKD. However, nearly half of all respondents reported that easy methods for spot urine creatinine-adjusted urinary protein assessments were unavailable. Awareness of the CKD risk stratification system and AKI definition was inadequate, and only 54.2% of respondents reported that they had received nutritional education for renal diseases. Although most of the respondents were nephrologists at university hospitals, 66.4% and 76.3% of respondents reported nephrology referrals and nephrology consultations, respectively, after AKI, suggesting an insufficient role for nephrologists. Finally, management models differed significantly, indicating that universal guidelines for CKD and AKI management are required across China. Several considerable challenges remain regarding CKD and AKI management in China, including inadequate knowledge and training systems, an absence of clinical protocols, and insufficient multidisciplinary cooperation.

  3. [A survey on diet manuals in Italian hospitals].

    Science.gov (United States)

    Donini, L M; Riti, M; Castellaneta, E; Ceccarelli, P; Civale, C; Passaretti, S; del Balzo, V; Cannella, C

    2009-01-01

    Hospital catering is very important to counteract the onset of malnutrition due to either undernutrition or overnutrition and for dietetic treatment. The aim of the study was to evaluate nutritional quality of the hospital dietetic manual used in some Italian hospitals and to analyze the role of the institutional Catering Service and of the Department of Clinical Nutrition. A survey has been carried out, in some Italian hospitals, using a questionnaire to point out the characteristics of hospitals, the typology of catering service, of the diets and of the staff of the Department of Clinical Nutrition. Only 22% of the hospitals has answered; three Italian regions (Umbria, Molise, Basilicata) are completely missing; -each hospital has a specific dietetic manual in most cases completely different from structure and nutritional quality point of view; the staff acting in this field is absolutely insufficient in term of numerousness and of professional typologies. Hospital in-patients are not homogeneous as for age, dietary needs and diseases, so it's necessary to treat them with an ad hoc nutritional intervention not established in advance in a dietetic manual; if from an organisation point of view it is necessary to have such a dietetic manual, it has to be based on nutritional guidelines and recommended dietary allowances.

  4. Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes.

    Science.gov (United States)

    Ariaratnam, Christeine A; Sheriff, Mohamed H Rezvi; Arambepola, Carukshi; Theakston, R David G; Warrell, David A

    2009-10-01

    Of 860 snakes brought to 10 hospitals in Sri Lanka with the patients they had bitten, 762 (89%) were venomous. Russell's vipers (Daboia russelii) and hump-nosed pit vipers (Hypnale hypnale) were the most numerous and H. hypnale was the most widely distributed. Fifty-one (6%) were misidentified by hospital staff, causing inappropriate antivenom treatment of 13 patients. Distinctive clinical syndromes were identified to aid species diagnosis in most cases of snake bite in Sri Lanka where the biting species is unknown. Diagnostic sensitivities and specificities of these syndromes for envenoming were 78% and 96% by Naja naja, 66% and 100% by Bungarus caeruleus, 14% and 100% by Daboia russelii, and 10% and 97% by Hypnale hypnale, respectively. Although only polyspecific antivenoms are used in Sri Lanka, species diagnosis remains important to anticipate life-threatening complications such as local necrosis, hemorrhage and renal and respiratory failure and to identify likely victims of envenoming by H. hypnale who will not benefit from existing antivenoms. The technique of hospital-based collection, labeling and preservation of dead snakes brought by bitten patients is recommended for rapid assessment of a country's medically-important herpetofauna.

  5. The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey.

    Science.gov (United States)

    Forster, Della A; McKay, Heather; Powell, Rhonda; Wahlstedt, Emma; Farrell, Tanya; Ford, Rachel; McLachlan, Helen L

    2016-04-01

    There is limited evidence regarding the provision of home-based postnatal care, resulting in a weak evidence-base for policy formulation and the further development of home-based postnatal care services. To explore the structure and organisation of public hospital home-based postnatal care in Victoria, Australia. An online survey including mostly closed-ended questions was sent to representatives of all public maternity providers in July 2011. The response rate of 87% (67/77) included rural (70%; n=47), regional (15%; n=10) and metropolitan (15%; n=10) services. The majority (96%, 64/67) provided home-based postnatal care. The median number of visits for primiparous women was two and for multiparous women, one. The main reason for no visit was the woman declining. Two-thirds of services attempted to provide some continuity of carer for home-based postnatal care. Routine maternal and infant observations were broadly consistent across the services, and various systems were in place to protect the safety of staff members during home visits. Few services had a dedicated home-based postnatal care coordinator. This study demonstrates that the majority of women receive at least one home-based postnatal visit, and that service provision on the whole is similar across the state. Further work should explore the optimum number and timing of visits, what components of care are most valued by women, and what model best ensures the timely detection and prevention of postpartum complications, be they psychological or physiological. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Knowledge, attitude, and practice toward cervical cancer among women attending Obstetrics and Gynecology Department: A cross-sectional, hospital-based survey in South India.

    Science.gov (United States)

    Narayana, G; Suchitra, M Jyothi; Sunanda, G; Ramaiah, J Dasaratha; Kumar, B Pradeep; Veerabhadrappa, K V

    2017-01-01

    Cervical cancer-related deaths among women in India are often due to late diagnosis of disease. Knowledge about disease and early screening is the most effective measure for cervical cancer prevention. Lack of awareness, negative attitude, and poor practice about cervical cancer and screening are the major causes to increase the incidence of disease. The study is designed to assess knowledge, attitude, and practice (KAP) toward cervical cancer, screening, and prevention. A cross-sectional, hospital-based survey was conducted in women attending Obstetrics and Gynecology Department of a secondary care referral hospital. A total of 403 subjects were enrolled and subjected for interview using prevalidated KAP questionnaire on cervical cancer. Descriptive statistics were used to represent the sociodemographic characteristics and KAP levels. Association of sociodemographic variables with KAP levels is determined using Chi-square test. Most of (301; 74.6%) the respondents had heard about cervical cancer and majority of them are heard from media (168; 41.6%) and friends (83; 20.5%). Most women knew symptoms (259; 64.2%), risk factors (253; 62.7%), screening methods (310; 76.9%), and preventive measures (249; 61.7%) for cervical cancer. More than half of the women (252; 62.5%) having positive attitude toward screening. More than three-fourth of women (349; 86.6%) are not having practice toward cervical cancer screening. Sociodemographic characteristics are strongly associated with KAP levels. Although women are having good knowledge, positive attitude toward cervical cancer screening and prevention still there is a gap to transform it into practice. There is a need for more educational programs to connect identified knowledge slits and uplift of regular practice of cervical cancer screening.

  7. [Patient safety culture in hospitals: experiences in planning, organising and conducting a survey among hospital staff].

    Science.gov (United States)

    van Vegten, Amanda; Pfeiffer, Yvonne; Giuliani, Francesca; Manser, Tanja

    2011-01-01

    This article presents the first hospital-wide survey on patient safety climate, involving all staff (medical and non-medical), in the German-speaking area. Its aim is to share our experiences with planning, organising and conducting this survey. The study was performed at the university hospital in Zurich and had a response rate of 46.8% (2,897 valid questionnaires). The survey instrument ("Patientensicherheitsklimainventar") was based on the Hospital Survey on Patient Safety Culture (AHRQ). Primarily it allowed for assessing the current patient safety climate as well as identifying specific areas for improvement and creating a hospital-wide awareness and acceptance for patient safety issues and interventions (e.g., the introduction of a Critical Incident Reporting System [CIRS]). We discuss the basic principles and the feedback concept guiding the organisation of the overall project. Critical to the success of this project were the guaranteed anonymity of the respondents, adequate communication through well-established channels within the organisation and the commitment of the management across all project phases. Copyright © 2011. Published by Elsevier GmbH.

  8. A survey of hospital outpatient services for chronic diseases in ...

    African Journals Online (AJOL)

    A survey of hospital outpatient services for chronic diseases in Gauteng. ... aspects of the organisation of services, and indirect indicators of patient care. Design. A postal survey of services for asthma, epilepsy, diabetes and hypertension at ...

  9. A survey of medical quality assurance programs in Ontario hospitals.

    OpenAIRE

    Barrable, B

    1992-01-01

    OBJECTIVE: To determine the prevalence and types of medical quality assurance practices in Ontario hospitals. DESIGN: Survey. SETTING: All teaching, community, chronic care, rehabilitation and psychiatric hospitals that were members of the Ontario Hospital Association as of May 1990. PARTICIPANTS: The person deemed by the chief executive officer of each hospital to be most responsible for medical administration. INTERVENTION: A questionnaire to obtain information on each hospital's use of cri...

  10. A survey of the radiographic cassettes disinfection of university hospitals in seoul

    International Nuclear Information System (INIS)

    Kweon, Dae Cheol; Park, Peom; Kim, Moon Sun; Kim, Dong Sung

    2001-01-01

    The purpose of this study is to prevent nosocomial infection in patients through contact of radiographic cassettes. Data were collected from radiographers working in 29 university hospitals in Seoul in February and March 2001. Radiographic cassettes were disinfected daily in 5 hospitals, weekly in 4 hospitals, monthly in 5 hospitals, bimonthly in 1 hospital and once every three months in another hospital. 12 other hospitals do not practice regular disinfections of radiographic cassettes. Gauze soaked in disinfectant solution is used in 7 hospitals while 11 hospitals used cotton and cloth soaked in disinfectant solution to clean the radiographic cassettes. 26 hospitals used 99% alcohol based disinfectant solutions while 3 hospitals used 75% alcohol based disinfectant, 26 hospitals use of intercourse cassettes outpatients and in patients. In 26 hospitals, all patients shared the same set of radiographic cassettes used in the hospitals, or in 26 hospitals, separate sets of radiographic cassettes are used for outpatients and inpatients. Separate sets of cassettes are used for ICU and inpatients in 6 others hospitals. 23 hospitals used the same sets of radiographic cassettes for all their patients. radiographic cassettes are cleaned in wash area in the study room of the radiographic department in 17 hospitals. 12 other hospitals do not have designated cleaning areas for the cassettes. All radiographers practiced hands washing with soap. All 29 hospitals surveyed have infection control committee. However, only 9 out of the 29 hospitals surveyed provided Infection · disinfections control education to radiographers. Only 3 hospitals have radiographers sitting in the infection control committee. Infection management education is conducted in 63 hospitals annually, twice a year in 1 hospital and once every 3 months in 2 hospitals

  11. Hospital Value-Based Purchasing

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Value-Based Purchasing (VBP) is part of the Centers for Medicare and Medicaid Services (CMS) long-standing effort to link Medicares payment system to a...

  12. Surveying hospital nurses to discover educational needs and preferences.

    Science.gov (United States)

    Lindsay, J Michael; Oelschlegel, Sandy; Earl, Martha

    2017-07-01

    The author investigated the educational needs of nurses in an American Nurses Credentialing Center Magnet hospital to determine topics of interest, instruction time and delivery preferences, and interest in a research information skills certificate provided by the library. A 9-question survey was distributed to 1,500 nursing staff of the hospital through email. Surveys were completed by 865 respondents, which represented a response rate of 58%. The majority of respondents were registered nurses, licensed practical nurses, and paramedics (81%), and day-shift workers (65%). For education topics, nursing staff placed the highest priority on finding health-related mobile apps for professionals and developing evidence-based research skills. For mode of delivery, respondents expressed a preference for unit-based in-service, computer-based tutorials, and hands-on computer training. Most (70%) respondents expressed an interest in participating in a research information skills certificate program. Our survey results reveal an avenue for reinvigorating and updating the library's educational program to match the needs of nursing staff and may offer valuable insight for other libraries seeking to do the same.

  13. The assessment of Picture Archiving and Communication System based on Canadian Infoway PACS Opinion Survey in Teaching Hospitals of Shiraz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Fatemeh Bahador

    2017-10-01

    Full Text Available Introduction: Today the use of information technology in accordance with the rapid environmental changes and flexibility acquisition is necessary and unavoidable. Picture Archiving and Communication System (PACS is one of the medical information technology used in health facilities. PACS provides the images archive and transmission possibility electronically in different units of the teaching and treatment centers. This study aimed to assess the PACS system in teaching hospitals of Shiraz University of Medical Sciences based on a survey of Canadian Infoway. Method: This descriptive cross-sectional study was performed on 53 individuals selected through Two-Stage Stratified Random Sampling. The study population consisted of 156 PACS users in Shiraz University of Medical Sciences hospitals which were equipped with the PACS system in 2015. Data were collected by the valid and reliable customized questionnaire of Canadian Infoway. The reliability was measured by a pilot study on 25 PACS users; Cronbach’s Alpha was estimated 0.78. Data were analyzed using SPSS 18. Also, frequency, mean, standard deviation were used. Results: The results are presented in three sections: environment (Background Variables, benefits and challenges of PACS. As to the system availability, 20.8% of the users in the clinic, 75.5% in the diagnostic imaging department, only 3.8% in offices had access to the PACS. As to system accessibility, 49.1% of the users just had access to tests, 5.7% only to the reports, and 45.3% to both reports and tests. With respect to benefits of PACS, the mean was 4.16 (SD: 0.5 (five-point scale 1-5 estimated, and in challenges, the mean was 3.48(SD: 0.5 (five-point scale 1-5. Conclusion: The results showed that although PACS could eliminate many restrictions concerning the use of radiology images and films, there were challenges in this regard. Users are recommended to have access to PACS in all clinics, physicians’ offices, and diagnostic

  14. The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey.

    Science.gov (United States)

    Lee, Hye Ah; Han, Hyejin; Lee, Seonhwa; Park, Bomi; Park, Bo Hyun; Lee, Won Kyung; Park, Ju Ok; Hong, Sungok; Kim, Young Taek; Park, Hyesook

    2018-03-13

    It has been suggested that health risks are affected by geographical area, but there are few studies on contextual effects using multilevel analysis, especially regarding unintentional injury. This study investigated trends in unintentional injury hospitalization rates over the past decade in Korea, and also examined community-level risk factors while controlling for individual-level factors. Using data from the 2004 to 2013 Korea National Hospital Discharge Survey (KNHDS), trends in age-adjusted injury hospitalization rate were conducted using the Joinpoint Regression Program. Based on the 2013 KNHDS, we collected community-level factors by linking various data sources and selected dominant factors related to injury hospitalization through a stepwise method. Multilevel analysis was performed to assess the community-level factors while controlling for individual-level factors. In 2004, the age-adjusted unintentional injury hospitalization rate was 1570.1 per 100,000 population and increased to 1887.1 per 100,000 population in 2013. The average annual percent change in rate of hospitalizations due to unintentional injury was 2.31% (95% confidence interval: 1.8-2.9). It was somewhat higher for females than for males (3.25% vs. 1.64%, respectively). Both community- and individual-level factors were found to significantly influence unintentional injury hospitalization risk. As community-level risk factors, finance utilization capacity of the local government and neighborhood socioeconomic status, were independently associated with unintentional injury hospitalization after controlling for individual-level factors, and accounted for 19.9% of community-level variation in unintentional injury hospitalization. Regional differences must be considered when creating policies and interventions. Further studies are required to evaluate specific factors related to injury mechanism.

  15. The ADOPT-LC score: a novel predictive index of in-hospital mortality of cirrhotic patients following surgical procedures, based on a national survey.

    Science.gov (United States)

    Sato, Masaya; Tateishi, Ryosuke; Yasunaga, Hideo; Horiguchi, Hiromasa; Matsui, Hiroki; Yoshida, Haruhiko; Fushimi, Kiyohide; Koike, Kazuhiko

    2017-03-01

    We aimed to develop a model for predicting in-hospital mortality of cirrhotic patients following major surgical procedures using a large sample of patients derived from a Japanese nationwide administrative database. We enrolled 2197 cirrhotic patients who underwent elective (n = 1973) or emergency (n = 224) surgery. We analyzed the risk factors for postoperative mortality and established a scoring system for predicting postoperative mortality in cirrhotic patients using a split-sample method. In-hospital mortality rates following elective or emergency surgery were 4.7% and 20.5%, respectively. In multivariate analysis, patient age, Child-Pugh (CP) class, Charlson Comorbidity Index (CCI), and duration of anesthesia in elective surgery were significantly associated with in-hospital mortality. In emergency surgery, CP class and duration of anesthesia were significant factors. Based on multivariate analysis in the training set (n = 987), the Adequate Operative Treatment for Liver Cirrhosis (ADOPT-LC) score that used patient age, CP class, CCI, and duration of anesthesia to predict in-hospital mortality following elective surgery was developed. This scoring system was validated in the testing set (n = 986) and produced an area under the curve of 0.881. We also developed iOS/Android apps to calculate ADOPT-LC scores to allow easy access to the current evidence in daily clinical practice. Patient age, CP class, CCI, and duration of anesthesia were identified as important risk factors for predicting postoperative mortality in cirrhotic patients. The ADOPT-LC score effectively predicts in-hospital mortality following elective surgery and may assist decisions regarding surgical procedures in cirrhotic patients based on a quantitative risk assessment. © 2016 The Authors Hepatology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Hepatology.

  16. Picture archiving and communication systems (PACS) for hospitals, a survey

    International Nuclear Information System (INIS)

    Haar Romeny, B.M. ter; Graaf, C.N. de; Waes, P.F.G.M. van; Rijk, P.P. van; Helder, J.C.; Valk, J.P.J. de

    1985-01-01

    In this article a survey is given for Picture Archiving and Communication Systems (PACS). Several aspects of PACS are treated, as image management, the introduction of the system, expenses etc. Special reference is made to the component parts of PACS: image stations, memory, network, software and coupling to the hospital information system. The introduction of PACS in Dutch hospitals is described. (Auth.)

  17. Hospital-based child protection teams that care for parents who abuse or neglect their children recognize the need for multidisciplinary collaborative practice involving perinatal care and mental health professionals: a questionnaire survey conducted in Japan.

    Science.gov (United States)

    Okato, Ayumi; Hashimoto, Tasuku; Tanaka, Mami; Tachibana, Masumi; Machizawa, Akira; Okayama, Jun; Endo, Mamiko; Senda, Masayoshi; Saito, Naoki; Iyo, Masaomi

    2018-01-01

    Child abuse and/or neglect is a serious issue, and in many cases, parents are the perpetrators. Hospital-based child protection teams (CPTs) play pivotal roles in the management of not only abused and/or neglected children but also of their parents; this is generally conducted through multidisciplinary practice. The aim of this study is to survey hospital-based CPT members to determine the professions they perceive to be most applicable to participation in CPTs. The participants were members of CPTs affiliated with hospitals that had pediatric emergency departments and which were located in Chiba Prefecture; specifically, 114 CPT members from 23 hospitals responded to this survey. The two main questionnaire items concerned are as follows: 1) each respondent's evaluation of conducting assessments, providing support, and implementing multidisciplinary collaborative practice in the treatment of abusive and negligent parents, and 2) each CPT member's opinion on the professions that are most important for CPT activities. An exploratory factor analysis (EFA) was performed to explore the factor structure of the data, and a correlation analysis was performed using the result obtained. The EFA returned two factors: multidisciplinary collaborative practice (α = 0.84) and assessment and support (α = 0.89). A correlational analysis showed that multidisciplinary collaborative practice had a positive correlation for obstetricians ( r = 0.315, p = 0.001), neonatologists ( r = 0.261, p = 0.007), midwives ( r = 0.248, p = 0.011), and psychiatrists ( r = 0.194, p = 0.048); however, assessment and support was only significantly correlated with midwives ( r = 0.208, p = 0.039). This study showed that hospital-based CPT members highly evaluate multidisciplinary collaborative practice for the management of abusive and/or negligent parents, and they believe that, in addition to pediatric physicians and nurses, perinatal care and mental health professionals are the most important

  18. Preventing hospital malnutrition: a survey on nutritional policies in an Italian University Hospital.

    Science.gov (United States)

    Annetta, M G; Pittiruti, M; De Rosa, S; Franchi, P; Pintaudi, G; Caricato, A; Antonelli, M

    2015-11-01

    A proper strategy for fighting hospital malnutrition should include nutritional screening of all hospitalized patients, adequate utilization of the Hospital facilities - such as Clinical Nutrition Services or Nutrition Teams - and an adequate algorithm for the adoption of proper nutrition support (oral, enteral or parenteral) with proper timing. The main aim of the present study was to investigate the current policies of different non-intensive wards of our institution (a 1100 beds University Hospital) in terms of prevention of hospital malnutrition. We conducted a one-day survey to verify the current policies of nutritional screening and the indication to nutritional support in adult patients, interviewing nurses and physicians of our non-intensive hospital wards. A total of 29 wards were considered, which sum up to 755 hospitalized patients. We found that nutritional screening at admission is routinely assessed only in 41% of wards and that oral nutrient intake is controlled regularly only in 72%. Indication to clinical nutrition support and specifically to artificial nutrition is not consistent with the current international guidelines. Only 14% of patients were receiving artificial nutrition at the moment of the survey and the majority of them were given parenteral nutrition rather than enteral feeding. Our survey confirmed that in large hospitals the main barriers to the fight against hospital malnutrition are the lack of knowledge and/or commitment by nurses and physicians as well as the lack of well-defined hospital policies on early nutritional screening, surveillance of nutritional status and indication to nutrition support.

  19. Medical Student Education in State Psychiatric Hospitals: A Survey of US State Hospitals.

    Science.gov (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Kennedy, Cheryl; Walker, Mary O; Mayerhoff, David

    2016-04-01

    State hospitals may be underutilized in medical education. US state psychiatric hospitals were surveyed on current and potential psychiatry medical student education. A 10-item questionnaire, with multiple response formats, was sent to identified hospitals in late 2012. Ninety-seven of 221 hospitals contacted responded. Fifty-three (55%) reported current medical student education programs, including 27 clinical clerkship rotations. Education and training in other disciplines was prevalent in hospitals both with and without medical students. The large majority of responders expressed enthusiasm about medical education. The most frequent reported barrier to new programs was geographic distance from the school. Limited resources were limiting factors for hospitals with and without current programs. Only a minority of US state hospitals may be involved in medical student education. While barriers such as geographic distance may be difficult to overcome, responses suggest opportunities for expanding medical education in the state psychiatric hospitals.

  20. An insight into frequency and predictors leading psychiatric patients to visit faith healers: A hospital-based cross-sectional survey, Karachi, Pakistan.

    Science.gov (United States)

    Khoso, Aneeta; Soomro, Rafiq Ahmed; Quraishy, Ayesha Muquim; Khan, Hammad Ali; Ismail, Saba; Nazaz, Mehrunnisa; Younus, Sana; Zainab, Saima

    2018-05-01

    Psychiatric illnesses have recently escalated in numbers, with patients resorting to various forms of healthcare providers, including faith healers. This delays early psychiatric treatment, resulting in further mental health deterioration of the patient. Various factors impact the mode of treatment preferred by psychiatric patients. To determine the frequency of psychiatric patients visiting faith healers, presenting at the outpatient department of Liaquat National Hospital, Karachi, Pakistan, and to explore the predictors that direct them toward visiting faith healers. This cross-sectional survey was conducted using a semi-structured pre-tested questionnaire, employing a total of 219 male and female psychiatric patients. Patients were recruited through non-random consecutive sampling technique. SPSS 18 was used for statistical analysis. About 32% of the patients had visited a faith healer in their lifetime. Frequency of current visitors declined; the most frequent reason being stated was no relief from their treatment. Students, patients of upper middle class and those coming for initial visit to a psychiatrist were more likely to visit a faith healer. Patients who knew of someone previously visiting a faith healer were less likely to have visited a faith healer. This study highlights the importance of a multisectoral approach to dealing with psychiatric patients to help in bridging the treatment gap in mental health.

  1. A Survey of Job Satisfaction among Staff of Jundishapur Medical Teaching Hospitals in Ahvaz; Based on Herzberg's Two-Factor Model

    Directory of Open Access Journals (Sweden)

    Elham Amiri

    2017-06-01

    Full Text Available Background and Objectives: Job satisfaction is the most important factor affecting the performance and productivity of the organization. The purpose of this study was to assess job satisfaction among staff of Jundishapur medical teaching hospitals; based on Herzberg's      two-factor model. Material and Methods: This was a cross-sectional study. The sample size of 147 was calculated. Stratified sampling method was used. The questionnaire used to collect data consisted of demographic characteristics and job satisfaction in a Likert scale. Data were analyzed using descriptive statistics (mean score and standard deviation and analytical statistics (Parametric test in SPSS16 software. Results: In survival factors, the highest average belonged to salary subscale with mean score     (3.35 ± 1.05. The other subscales were estimated relatively inappropriate .Regarding motivational factors; all subscales were estimated relatively inappropriate. The recognition subscale showed a significant association with age (P Conclusion: In order to enhance the efficiency of hospital staff, in addition to the domains that prevent staff from quitting their job, it needs to emphasize on their motivation as well.

  2. Defining a caring hospital by using currently implemented survey tools.

    Science.gov (United States)

    Jennings, Nancy

    2010-09-01

    Health care organizations are constantly striving to provide a more cost-effective and higher quality treatment within a caring environment. However, balancing the demands of regulatory agencies with the holistic needs of the patient is challenging. Further challenging is how to define those hospitals that provide an exceptional caring environment for their patients. By using survey tools that are already being administered in hospital settings, the opportunity exists to analyze the results obtained from these tools to define a hospital as a caring organization without the added burden of separate data collection.

  3. Use of Facebook by Hospitals in Taiwan: A Nationwide Survey

    Directory of Open Access Journals (Sweden)

    Po-Chin Yang

    2018-06-01

    Full Text Available Background: Social media advertising has become increasingly influential in recent years. Because Facebook has the most active users worldwide, many hospitals in Taiwan have created official Facebook fan pages. Our study was to present an overview of official Facebook fan pages of hospitals in Taiwan. Methods: All 417 hospitals were surveyed about their use of Facebook fan pages in December 2017. The last update time, posts in the past 30 days, number of “Likes”, and other features were analyzed and stratified according to the accreditation statuses of the hospitals. Results: In Taiwan, only 51.1% (n = 213 of the hospitals had an official Facebook fan page. Among these hospitals, 71.8% (n = 153 had updated their pages in the past 30 days, although 89.2% (n = 190 provided online interactions. Academic medical centers tended to have more “Likes” than regional and local community hospitals (on average 5947.4, 2644.8, and 1548.0, respectively. Conclusions: In spite of the popularity of Facebook among the general population, most hospitals in Taiwan do not seem to make good use of this kind of social media. The reasons for the use and nonuse of Facebook on the part of both hospitals and patients deserve further investigation.

  4. Use of Facebook by Hospitals in Taiwan: A Nationwide Survey.

    Science.gov (United States)

    Yang, Po-Chin; Lee, Wui-Chiang; Liu, Hao-Yen; Shih, Mei-Ju; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang

    2018-06-06

    Background : Social media advertising has become increasingly influential in recent years. Because Facebook has the most active users worldwide, many hospitals in Taiwan have created official Facebook fan pages. Our study was to present an overview of official Facebook fan pages of hospitals in Taiwan. Methods : All 417 hospitals were surveyed about their use of Facebook fan pages in December 2017. The last update time, posts in the past 30 days, number of “Likes”, and other features were analyzed and stratified according to the accreditation statuses of the hospitals. Results : In Taiwan, only 51.1% ( n = 213) of the hospitals had an official Facebook fan page. Among these hospitals, 71.8% ( n = 153) had updated their pages in the past 30 days, although 89.2% ( n = 190) provided online interactions. Academic medical centers tended to have more “Likes” than regional and local community hospitals (on average 5947.4, 2644.8, and 1548.0, respectively). Conclusions : In spite of the popularity of Facebook among the general population, most hospitals in Taiwan do not seem to make good use of this kind of social media. The reasons for the use and nonuse of Facebook on the part of both hospitals and patients deserve further investigation.

  5. Psychometric properties of the Hospital Survey on Patient Safety Culture for hospital management (HSOPS_M

    Directory of Open Access Journals (Sweden)

    Pfeiffer Yvonne

    2011-07-01

    Full Text Available Abstract Background From a management perspective, it is necessary to examine how a hospital's top management assess the patient safety culture in their organisation. This study examines whether the Hospital Survey on Patient Safety Culture for hospital management (HSOPS_M has the same psychometric properties as the HSOPS for hospital employees does. Methods In 2008, a questionnaire survey including the HSOPS_M was conducted with 1,224 medical directors from German hospitals. When assessing the psychometric properties, we performed a confirmatory factor analysis (CFA. Additionally, we proved construct validity and internal consistency. Results A total of 551 medical directors returned the questionnaire. The results of the CFA suggested a satisfactory global data fit. The indices of local fit indicated a good, but not satisfactory convergent validity. Analyses of construct validity indicated that not all safety culture dimensions were readily distinguishable. However, Cronbach's alpha indicated that the dimensions had an acceptable level of reliability. Conclusion The analyses of the psychometric properties of the HSOPS_M resulted in reasonably good levels of property values. Although the set of dimensions within the HSOPS_M needs further scale refinement, the questionnaire covers a broad range of sub-dimensions and supplies important information on safety culture. The HSOPS_M, therefore, is eligible to measure safety culture from the hospital management's points of view and could be used in nationwide hospital surveys to make inter-organisational comparisons.

  6. Industry Based Monkfish Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monkfish industry leaders expressed concerns that the NEFSC bottom trawl surveys did not sample in all monkfish habitats; particularly the deeper water outside the...

  7. Using the Theory of Planned Behavior to explore hospital-based nurses' intention to use peripherally inserted central catheter (PICC): a survey study.

    Science.gov (United States)

    Bertani, Laura; Carone, Maria; Caricati, Luca; Demaria, Serena; Fantuzzi, Silvia; Guarasci, Alessandro; Pirazzoli, Luca

    2016-11-22

    The peripherally inserted central catheters (PICC) have become an alternative to the traditional CVC. PICCs are usually inserted by trained nurses who decided to attend and complete a special training on PICC insertion and management. The present work aimed to investigate the intention of using PICC in a sample of hospital-based nurses using the theory of planned behavior as theoretical framework. A cross-sectional design was used in which a questionnaire was delivered to 199 nurses. According to the theory of planned behavior, the attitude toward the use of PICC, subjective norms and perceived self-efficacy predicted the intention to use PICC. Contrary to the expectations, the effect of subjective norms on intention to use PICC was mediated by attitude and self-efficacy. Finally, age of participants was negatively related to the intention to use the PICC. The theory of planned behavior offers a useful framework to explain nurses' intention to use PICC. Shared norms favoring the use of PICC seem to increase both nurse's positive attitudes and self-efficacy whit respect to the use of these devices. Thus, it appears that to train professionals individually does not necessarily results in an increased use of PICC.

  8. Web-based Surveys: Changing the Survey Process

    OpenAIRE

    Gunn, Holly

    2002-01-01

    Web-based surveys are having a profound influence on the survey process. Unlike other types of surveys, Web page design skills and computer programming expertise play a significant role in the design of Web-based surveys. Survey respondents face new and different challenges in completing a Web-based survey. This paper examines the different types of Web-based surveys, the advantages and challenges of using Web-based surveys, the design of Web-based surveys, and the issues of validity, error, ...

  9. Questionnaire-based survey on structural quality of hospitals and nursing homes for the elderly, their staffing with infection control personal, and implementation of infection control measures in Germany.

    Science.gov (United States)

    Kramer, A; Assadian, O; Helfrich, J; Krüger, C; Pfenning, I; Ryll, S; Perner, A; Loczenski, B

    2013-01-01

    From January to May 2012, 1,860 hospitals throughout Germany received a questionnaire encompassing 77 items. Additionally, 300 outpatient care services and 310 nursing homes for elderly in Berlin also received a 10-item questionnaire asking on their implemented infection control practices. All questionnaires were anonymous. A total of 229 completed questionnaires from hospitals, 14 questionnaires from outpatient care services, and 16 questionnaires from nursing homes were eligible for further analysis. The lack of Infection Control physicians was identified as the largest issue. In hospitals sized 400-999 beds a gap of 71%, and in hospitals sized ≥1,000 beds a gap of 17% was reported. Depending on the number of hospital beds, 13-29% of hospitals sized ≥100 beds reported not havening one infection control nurse. Since based on the number of beds in larger institutions or in facilities caring for high-risk patients several infection control nurses may be required, the deficiency in infection control nurses may even be higher, particularly in secondary and tertiary care facilities. Furthermore, the analysis revealed that the legal requirements for surveillance and reporting of notifiable infectious diseases have not yet been implemented in 11% of the facilities. The implementation of antibiotic strategies did show significant gaps. However, deficiencies in the implemented measures for the prevention of surgical site infections were less frequent. Yet 12% of the participants did not have a dedicated infection control concept for their surgical services. Eight percent of hospitals were not prepared for an outbreak management and 10% did not have established regulations for wearing surgical scrubs. Deficiencies in waste disposal and the control of air-conditioning systems were also noted. Based on the results of this survey, conclusions on the optimal resource allocation for further improvement of patient safety may be drawn. While all participating nursing homes had

  10. [Consumer surveys among hospitalized patients with lung disease].

    Science.gov (United States)

    Humborstad, O T; Omenaas, E; Gulsvik, A

    2001-03-30

    The aim of our survey was to record the experiences of hospitalised patients with respiratory diseases in order to create a more patient-friendly department. Our study included 609 patients (response rate 70%) with a median age of 64 years (range 13-91) who were discharged from the Department of Thoracic Medicine, Haukeland University Hospital in October 1991, 1992, 1994, 1995 and 1996. 268 patients had obstructive lung disease, 82 had lung cancer. They answered a questionnaire with 24 questions. Patient reception to the ward and staff knowledge of the patients' illnesses, were for the physicians rated as good or better by 92% and 79% and for the nurses by 94% and 70% respectively. 16% of the patients experienced insecurity, 17% anxiety, 12% helplessness, 9% loneliness and 12% little say in the decision making process. Trend factors for these emotional experiences were female sex, old age, obstructive lung disease and long stay in hospital. Patients aged 50 to 69 years and patients with lung cancer had the lowest rate of negative emotional experiences. Despite staff awareness of the prevalence and of the patients' emotional experiences and the risk factors involved, there was no clear reduction of negative experiences in the later surveys compared to the first survey. Patients in a university hospital with respiratory diseases showed unchanged experiences of health care and personal emotions in repeated surveys over a period of five years.

  11. Hospitality managers’ price-ending beliefs: a survey and applications

    OpenAIRE

    Schindler, Robert M.; Parsa, H. G.; Naipaul, Sandra

    2011-01-01

    The use of “just-below” pricing (such as pricing an item at $6.99 or $6.95, rather than $7.00) has been common in some segments of the hospitality industry (such as quick-service and mid-scale dining). The results of a detailed survey of the price-ending beliefs of hospitality managers show that many believe that just-below prices connote good value and roundnumber prices connote high quality. Furthermore, the majority of these managers believe that consumers tend to drop off or otherwise giv...

  12. Diarrheal diseases and hospitalization of children under five years of age according to population-based surveys in the State of Pernambuco, Brazil, in the years 1997 and 2006.

    Science.gov (United States)

    Vasconcelos, Maria Josemere Oliveira Borba; Rissin, Anete; Figueiroa, José Natal; Lira, Pedro Israel Cabral de; Batista Filho, Malaquias

    2018-03-01

    The scope of this paper was to assess the temporal and geographical trends of diarrhea and its implications on the demands of hospitalizations of children under five years of age in the state of Pernambuco in 1997 and 2006. Databases of two population-based surveys were assessed with probabilistic samples of 2078 children (1997) and 1650 children (2006) evaluated in 18 municipalities of Pernambuco, including the Metropolitan Region of Recife, Urban Interior and Rural Interior. Prevalence was considered to involve the occurrence of cases on the day or in the two weeks prior to the interview and as admissions, service cases with minimal hospital stay of 24 hours in the period, covering up to one year before the interview. The prevalence of diarrhea in Pernambuco had a statistically non-significant decline (19.8% to 18.1%; p = 0.192). However, a statistically-significant reduction was observed (16.9% to 10.5%; p = 0.003) in the Metropolitan Region of Recife. The number of admissions increased by more than double (2.7% to 5.5% in the State and from 1.6% to 3.8% within the Metropolitan Region of Recife), in contrast with national trends. Therefore, diarrhea in the State appears as the main component of the demands of pediatric hospitalizations during the period under scrutiny.

  13. Intranet usage and potential in acute care hospitals in the United States: survey-2000.

    Science.gov (United States)

    Hatcher, M

    2001-12-01

    This paper provides the results of the Survey-2000 measuring Intranet and its potential in health care. The survey measured the levels of Internet and Intranet existence and usage in acute care hospitals. Business-to-business electronic commerce and electronic commerce for customers were measured. Since the Intranet was not studied in survey-1997, no comparisons could be made. Therefore the results were presented and discussed. The Intranet data were compared with the Internet data and statistically significant differences were presented and analyzed. This information will assist hospitals to plan Internet and Intranet technology. This is the third of three articles based upon the results of the Survey-2000. Readers are referred to prior articles by the author, which discusses the survey design and provides a tutorial on technology transfer in acute care hospitals.(1) The first article based upon the survey results discusses technology transfer, system design approaches, user involvement, and decision-making purposes. (2) The second article based upon the survey results discusses distribution of Internet usage and rating of Internet usage applied to specific applications. Homepages, advertising, and electronic commerce are discussed from an Internet perspective.

  14. Conducting Web-based Surveys.

    OpenAIRE

    David J. Solomon

    2001-01-01

    Web-based surveying is becoming widely used in social science and educational research. The Web offers significant advantages over more traditional survey techniques however there are still serious methodological challenges with using this approach. Currently coverage bias or the fact significant numbers of people do not have access, or choose not to use the Internet is of most concern to researchers. Survey researchers also have much to learn concerning the most effective ways to conduct s...

  15. Web-Based Surveys: Not Your Basic Survey Anymore

    Science.gov (United States)

    Bertot, John Carlo

    2009-01-01

    Web-based surveys are not new to the library environment. Although such surveys began as extensions of print surveys, the Web-based environment offers a number of approaches to conducting a survey that the print environment cannot duplicate easily. Since 1994, the author and others have conducted national surveys of public library Internet…

  16. Hospital-based child protection teams that care for parents who abuse or neglect their children recognize the need for multidisciplinary collaborative practice involving perinatal care and mental health professionals: a questionnaire survey conducted in Japan

    Directory of Open Access Journals (Sweden)

    Okato A

    2018-02-01

    Full Text Available Ayumi Okato,1 Tasuku Hashimoto,1 Mami Tanaka,2 Masumi Tachibana,1 Akira Machizawa,3 Jun Okayama,4 Mamiko Endo,5 Masayoshi Senda,6,7 Naoki Saito,5,7 Masaomi Iyo1 1Department of Psychiatry, Graduate School of Medicine, Chiba University, 2Division of Clinical Study on Juvenile Delinquency, Center for Forensic Mental Health, Chiba University, 3Department of Psychiatry, Chiba University Hospital, 4Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 5Department of Pediatrics, Graduate School of Medicine, Chiba University, 6Department of Pediatrics, Asahi General Hospital, 7Division of Clinical Forensic Medicine, Education and Research Center of Legal Medicine, Chiba University, Chiba, Japan Background: Child abuse and/or neglect is a serious issue, and in many cases, parents are the perpetrators. Hospital-based child protection teams (CPTs play pivotal roles in the management of not only abused and/or neglected children but also of their parents; this is generally conducted through multidisciplinary practice. The aim of this study is to survey hospital-based CPT members to determine the professions they perceive to be most applicable to participation in CPTs. Participants and methods: The participants were members of CPTs affiliated with hospitals that had pediatric emergency departments and which were located in Chiba Prefecture; specifically, 114 CPT members from 23 hospitals responded to this survey. The two main questionnaire items concerned are as follows: 1 each respondent’s evaluation of conducting assessments, providing support, and implementing multidisciplinary collaborative practice in the treatment of abusive and negligent parents, and 2 each CPT member’s opinion on the professions that are most important for CPT activities. An exploratory factor analysis (EFA was performed to explore the factor structure of the data, and a correlation analysis was performed using the result obtained. Results: The EFA

  17. Competency Based Hospital Radiopharmacy Training

    International Nuclear Information System (INIS)

    2010-01-01

    Quality management systems in nuclear medicine are vital to a high level of nuclear medicine (NM) practice. Trained and competent staffs are essential for achieving high standards and growth in NM. One of the key bottlenecks for NM is the shortfall in human resources, especially of radiopharmacists. There is an acute shortage in most Member States and in some countries an absence of nationally registered pharmacists with radiopharmacy experience. Most nuclear medicine facilities operate their radiopharmacies (commonly referred to as the hot laboratories) with the support of technologists and radiographers. Recent surveys have found the level of training amongst technologists to be extremely variable. Most had little or no training in hot laboratory practices. The survey also indicated the poor state of hot laboratories in many countries. Basic quality systems in the hot laboratory could be improved significantly with better training. This competency-based education manual is designed with those radiopharmacy practitioners in mind. This competency-based trainer's manual provides trainers in each of the IAEA regions with the essentials of a training programme for all radiopharmacy practitioners. The competency-based training is a two week programme followed up with three months of practice achievements. The syllabus provides a standardized approach to lectures, practical sessions, and interactive workshops focusing on critical aspects of hot laboratory practices. The trainers, with the assistance of this manual, can deliver essential skills, competencies, and underpinning knowledge to operate safely and effectively in their hot laboratory. The course focuses on simple but practical steps that could be undertaken to improve staff performance. In addition, a basic framework of quality management principles related to radiopharmacy practices is also covered. Further, the syllabus can be adapted to the particular needs and characteristics of any training centre, country

  18. Results of a hospital waste survey in private hospitals in Fars province, Iran

    International Nuclear Information System (INIS)

    Askarian, Mehrdad; Vakili, Mahmood; Kabir, Gholamhosein

    2004-01-01

    Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field

  19. Patient-reported outcomes at hospital discharge from Heart Centres, a national cross-sectional survey with a register-based follow-up

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Svanholm, Jette; Lauberg, Astrid

    2014-01-01

    Introduction: Patient reported health status, which includes symptom burden, functional status and quality of life, is an important measure of health. Differences in health status between diagnostic groups within cardiology have only been sparsely investigated. These outcomes may predict morbidity...... in national registers. The following instruments are used: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire (B-IPQ), HeartQoL and Edmonton Symptom Assessment Scale. The following variables are collected from national registers: action diagnosis, procedures......, comorbidity, length of hospital stay, type of hospitalisation, visits to general practitioners and other agents in primary healthcare, dispensed prescription medication, vital status and cause of death. Labour market affiliation, sick leave, early retirement pension, educational degree and income...

  20. Virtual organization of hospital medical imaging: a user satisfaction survey.

    Science.gov (United States)

    Sicotte, Claude; Paré, Guy; Bini, Kobena Kra; Moreault, Marie-Pierre; Laverdure, Guy

    2010-12-01

    A virtual medical imaging department is an innovative and demanding organizational model, to the extent that the underlying goal is to achieve a continuous and advanced organizational integration of human and physical resources, clinical data, and clienteles. To better understand the kind of benefits offered, we conducted a survey of three groups of users--radiologists, radiological technologists, and medical specialists--working in a five-site virtual organization. We received 127 valid questionnaires, for an overall response rate of 66%. The assessments vary according to the use made of the system. The scores for system quality and the quality of the data produced were markedly higher for intra-hospital use (respectively 7.9 and 8.7 out of 10) than for inter-hospital use (5.4 and 7.0). Despite the negative assessments they made of inter-hospital use, users maintained a positive attitude toward some type of virtual organization of medical imaging. Indeed, the score for Overall satisfaction with the system was very high, 8.9 out of 10. Moreover, the scores for Intended future use of the system were very high for both intra-hospital use (8.9) and inter-hospital use (8.7). We also found significant differences in perceptions among user groups.

  1. Using the critical incident survey to assess hospital service quality.

    Science.gov (United States)

    Longo, B; Connor, G; Barnhart, T

    1993-01-01

    This survey was designed to determine "standards of excellence" in hospital services as defined by (a) former patients, (b) physicians, (c) hospital employees, and (d) corporate insurance subscribers. One hundred forty-seven (147) patients, 188 employees, and 20 corporate subscribers were interviewed by telephone, and 52 physicians were interviewed in their offices. The interview consisted of a single question: "Can you think of a time when, as a patient/employee/employer/physician, you had a particularly satisfying or dissatisfying experience with a local hospital?" Reported incidents were reviewed, and 239 "critical incidents" were identified. These incidents were classified into 12 descriptive categories relating to the underlying factors in the incident reports. Six focus groups were later held with participants segregated by the population pool they represented. These groups were asked to develop definitions of "excellence" in hospital service quality and standards for service which would "exceed expectations." The focus groups created 122 standards of excellence, which were classified into 43 categories. Overall, the largest percentages of corporate, physician, and employee critical incidents were classified as "Administrative Policy" issues. Patients most often reported "Nurturing" incidents as critical to their perceptions of hospital service quality.

  2. Relationship Between Hospital Performance on a Patient Satisfaction Survey and Surgical Quality.

    Science.gov (United States)

    Sacks, Greg D; Lawson, Elise H; Dawes, Aaron J; Russell, Marcia M; Maggard-Gibbons, Melinda; Zingmond, David S; Ko, Clifford Y

    2015-09-01

    The Centers for Medicare and Medicaid Services include patient experience as a core component of its Value-Based Purchasing program, which ties financial incentives to hospital performance on a range of quality measures. However, it remains unclear whether patient satisfaction is an accurate marker of high-quality surgical care. To determine whether hospital performance on a patient satisfaction survey is associated with objective measures of surgical quality. Retrospective observational study of participating American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) hospitals. We used data from a linked database of Medicare inpatient claims, ACS NSQIP, the American Hospital Association annual survey, and Hospital Compare from December 2, 2004, through December 31, 2008. A total of 103 866 patients older than 65 years undergoing inpatient surgery were included. Hospitals were grouped by quartile based on their performance on the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Controlling for preoperative risk factors, we created hierarchical logistic regression models to predict the occurrence of adverse postoperative outcomes based on a hospital's patient satisfaction scores. Thirty-day postoperative mortality, major and minor complications, failure to rescue, and hospital readmission. Of the 180 hospitals, the overall mean patient satisfaction score was 68.0% (first quartile mean, 58.7%; fourth quartile mean, 76.7%). Compared with patients treated at hospitals in the lowest quartile, those at the highest quartile had significantly lower risk-adjusted odds of death (odds ratio = 0.85; 95% CI, 0.73-0.99), failure to rescue (odds ratio = 0.82; 95% CI, 0.70-0.96), and minor complication (odds ratio = 0.87; 95% CI, 0.75-0.99). This translated to relative risk reductions of 11.1% (P = .04), 12.6% (P = .02), and 11.5% (P = .04), respectively. No significant relationship was noted between patient satisfaction

  3. Demographic Factors and Hospital Size Predict Patient Satisfaction Variance- Implications for Hospital Value-Based Purchasing

    Science.gov (United States)

    McFarland, Daniel C.; Ornstein, Katherine; Holcombe, Randall F.

    2016-01-01

    Background Hospital Value-Based Purchasing (HVBP) incentivizes quality performance based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population dense areas and could bias CMS reimbursement. Objective Assess nonrandom variation in patient satisfaction as determined by HCAHPS. Design Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized four highly predictive variables and hospitals were re-ranked accordingly. Setting 3,907 HVBP-participating hospitals. Patients 934,800 patient surveys, by most conservative estimate. Measurements 3,144 county demographics (U.S. Census), and HCAHPS. Results Hospital size and primary language (‘non-English speaking’) most strongly predicted unfavorable HCAHPS scores while education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals’ locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. Conclusions Demographic and structural factors (e.g., hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct. PMID:25940305

  4. Industry Based Survey (IBS) Yellowtail

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The "Southern New England Yellowtail Flounder Industry-Based Survey" was a collaboration between the Rhode Island Division of Fish and Wildlife and the fishing...

  5. Industry Based Survey (IBS) Cod

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The "Gulf of Maine Atlantic Cod Industry-Based Survey" was a collaboration of the Massachusetts Division of Marine Fisheries and the fishing industry, with support...

  6. Patient safety and nursing implication: Survey in Catalan hospitals.

    Science.gov (United States)

    Freixas Sala, Núria; Monistrol Ruano, Olga; Espuñes Vendrell, Jordi; Sallés Creus, Montserrat; Gallardo González, Mónica; Ramón Cantón, Carme; Bueno Domínguez, María José; Llinas Vidal, Montserrat; Campo Osaba, María Antonia

    This study aims to describe the implementation of the patient safety (PS) programs in catalan hospitals and to analyze the level of nursing involvement. Multicenter cross-sectional study. To obtain the data two questionnaires were developed; one addressed to the hospital direction and another to the nurse executive in PS. The survey was distributed during 2013 to the 65 acute care hospitals in Catalonia. The questionnaire was answered by 43 nursing directors and 40 nurse executive in PS. 93% of the hospitals responded that they had a PS Program and 81.4% used a specific scoreboard with PS indicators. The referent of the hospital in PS was a nurse in 55.8% of the centres. 92.5% had a system of notification of adverse effects with an annual average of 190.3 notifications. In 86% of the centres had a nurse involved in the PS program but only in the 16% of the centres the nurse dedication was at full-time. The nurse respondents evaluate the degree of implementation of the PBS program with a note of approved and they propound as improvement increase the staff dedicated to the PS and specific academic training in PS. The degree of implementation of programs for patient safety is high in Catalan acute hospitals, while the organizational structure is highly diverse. In more than half of the hospitals the PS referent was a nurse, confirming the nurse involvement in the PS programs. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital – National

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  8. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-06-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  9. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-03-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  10. National Hospital Discharge Survey: 2005 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    DeFrances, Carol J; Cullen, Karen A; Kozak, Lola Jean

    2007-12-01

    This report presents 2005 national estimates and selected trend data on the use of nonfederal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, Ninth Revision, Clinical Modification codes. The estimates are based on data collected through the National Hospital Discharge Survey. The survey has been conducted annually since 1965. In 2005, data were collected for approximately 375,000 discharges. Of the 473 eligible nonfederal short-stay hospitals in the sample, 444 (94 percent) responded to the survey. An estimated 34.7 million discharges from nonfederal short-stay hospitals occurred in 2005. Discharges used 165.9 million days of care and had an average length of stay of 4.8 days. Persons 65 years and over accounted for 38 percent of the hospital discharges and 44 percent of the days of care. The proportion of discharges whose status was described as routine discharge or discharged to the patient's home declined with age, from 91 percent for inpatients under 45 years of age to 41 percent for those 85 years and over. Hospitalization for malignant neoplasms decreased from 1990-2005. The hospitalization rate for asthma was the highest for children under 15 years of age and those 65 years of age and over. The rate was lowest for those 15-44 years of age. Thirty-eight percent of hospital discharges had no procedures performed, whereas 12 percent had four or more procedures performed. An episiotomy was performed during a majority of vaginal deliveries in 1980 (64 percent), but by 2005, it was performed during less than one of every five vaginal deliveries (19 percent).

  11. National survey of hospital child protection teams in Japan.

    Science.gov (United States)

    Tanoue, Koji; Senda, Masayoshi; An, Byongmun; Tasaki, Midori; Taguchi, Megumi; Kobashi, Kosuke; Oana, Shinji; Mizoguchi, Fumitake; Shiraishi, Yuko; Yamada, Fujiko; Okuyama, Makiko; Ichikawa, Kotaro

    2018-05-01

    This study aimed to investigate the penetration rate of child protection teams (CPTs) in medical institutions and associations between CPT functions and hospital services. We collected data in October of 2015 from 377 hospitals in Japan offering pediatric organ transplantation. The questionnaire included questions regarding the existence of a CPT, the number of child maltreatment cases discussed and reported per year, CPT functions including 21 items about staffing, manuals, meeting, prevention, education, and collaboration, and the services provided by the hospital. Of the 377 institutions, 122 (32.4%) answered the survey. There were significant associations between CPT functions and the number of pediatric beds (r = .27), number of pediatricians (r = .27), number of outpatients (r = .39), number of emergency outpatients (r = .28), and emergency medical care (p = .009). In a multiple regression analysis, CPT functions were significantly associated with the number of CPT members, pediatric outpatient numbers, and pediatric emergency outpatient numbers. Japan has no CPT guidelines that outline what CPTs should offer in terms of structure, staffing, functions, and systems. Hospitals with many pediatric and emergency outpatients are expected to play major roles in providing services such as specialty care, intensive care, and education. They are also expected to play a role in detecting and managing child maltreatment, and have, by their own initiative, improved their capacities to achieve these goals. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. National Hospital Discharge Survey: 2001 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola Jean; Owings, Maria F; Hall, Margaret J

    2004-06-01

    This report presents 2001 national estimates and selected trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Admission source and type, collected for the first time in the 2001 National Hospital Discharge Survey, are shown. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2001, data were collected for approximately 330,000 discharges. Of the 477 eligible non-Federal short-stay hospitals in the sample, 448 (94 percent) responded to the survey. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code numbers. Rates are computed with 2001 population estimates based on the 2000 census. The appendix includes a comparison of rates computed with 1990 and 2000 census-based population estimates. An estimated 32.7 million inpatients were discharged from non-Federal short-stay hospitals in 2001. They used 159.4 million days of care and had an average length of stay of 4.9 days. Common first-listed discharge diagnoses included delivery, psychoses, pneumonia, malignant neoplasm, and coronary atherosclerosis. Males had higher rates for procedures such as cardiac catheterization and coronary artery bypass graft, and females had higher rates for procedures such as cholecystectomy and total knee replacement. The rates of all cesarean deliveries, primary and repeat, rose from 1995 to 2001; the rate of vaginal birth after cesarean delivery dropped 37 percent during this period.

  13. A survey of radiology reporting practices in veterinary teaching hospitals

    International Nuclear Information System (INIS)

    Adams, W.M.

    1998-01-01

    Radiologists from 28 veterinary schools and one private teaching hospital responded to a survey questionnaire focused on diagnostic image reporting. Radiologists at 26 hospitals generated a hard copy report on essentially all imaging studies performed. At 25 hospitals, radiologists dictated and transcriptionists typed all or most reports; radiologists at two institutions typed all or some of their reports. At five hospitals, preliminary and/or final handwritten reports were generated. The range of reports generated per day was <10 to 40 per radiologist on duty. Seven respondents generated reports as films came from the processor and another 12 routinely generated reports the day the studies were completed. Clinician access to a processed report averaged 2 to 4 days after study was completed (reported range: several hours to 7 or more days). Fifteen responding radiologists personally mounted films from storage jackets for a majority of their reporting. Fourteen respondents generated reports from films mounted on motorized or stationary viewers. Nineteen respondents generated reports in a busy viewing area where they were frequently interrupted. Radiologists' impression of clinician and resident satisfaction regarding availability of radiology reports was that they were satisfied or very satisfied at 15 of the 29 hospitals. Five respondents reported that clinicians and residents were not concerned about availability of processed radiology reports. Thirteen radiologists were planning to change their reporting method within the next 2 years. The change most frequently sought (12 respondents) was to decrease turn-around time of reports. Ten radiologists indicated an interest in trying a voice recognition dictation system. The most common reasons given for not planning any changes in radiology reporting in the next 2 years were: limited number of radiologists (8) and 1 ''satisfied as is'' (7). Turn-around of radiology reports at these veterinary institutions averaged 2

  14. One year survey of hospitalized psoriatic patients and their treatment in Razi Hospital

    Directory of Open Access Journals (Sweden)

    Farnaghi F

    1998-05-01

    Full Text Available During one year survey, 77 psoriatic patients were hospitalized in the dermatology department of Razi Hospital. This comprised 19% of admitted patients in this period. 29% (n=22 of psoriatic patients had previous history of hospitalization. On admission, the mean age of patients was 32.8 years, the mean and peak age of disease onset were 26.46 and between 11-20 years, respectively. 14% (n=10 of the patients had a family history of psoriasis and 70% (n=7 of those with a positive family history had their age of onset under 20 years. Involvement of different regions was as follows: Scalp: 88% (n=68, nails: 53% (n=41 and joints (arthritis: 10% (n=8. Psoriasis was associated with scrotal tongue in 19% (n=13 and with geographic tongue in 10% (n=8 of patients. Regarding the medical treatment, the drugs which were used most frequently were tigason in 34% (n=41 and ditranol in 22% (n=26 of the cases. The mean duration of hospitalization was 39.29 days and most patients were discharged from the hospital in a good condition without any serious complication. During this period 9% of patients had a relapse of their disease.

  15. National Hospital Discharge Survey: 2002 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola J; Owings, Maria F; Hall, Margaret J

    2005-03-01

    This report presents 2002 national estimates and selected trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2002, data were collected for approximately 327,000 discharges. Of the 474 eligible non-Federal short-stay hospitals in the sample, 445 (94 percent) responded to the survey. An estimated 33.7 million inpatients were discharged from non-Federal short-stay hospitals in 2002. They used 164.2 million days of care and had an average length of stay of 4.9 days. Common first-listed discharge diagnoses included delivery, ischemic heart disease, psychoses, pneumonia, and malignant neoplasms. Inpatients had 6.8 million cardiovascular procedures and 6.6 million obstetric procedures. Males had higher rates for cardiac procedures such as cardiac catheterization and coronary artery bypass graft, but males and females had similar rates of pacemaker procedures. The number and rate of all cesarean deliveries, primary and repeat, rose from 1995 to 2002; the rate of vaginal birth after cesarean delivery dropped from 35.5 in 1995 to 15.8 in 2002.

  16. Trust-based or performance-based management: a study of employment contracting in hospitals.

    Science.gov (United States)

    Pettersen, Inger Johanne

    2011-01-01

    Hospitals are frequently changing managerial practices due to numerous public sector reforms taking place. In general, these reforms include the making and monitoring of contracts that regulate relations between the hospitals and their professional staffs. The aim of this paper is to discuss some main characteristics of the contracts that regulate the perceived relations between physicians as employees and the public hospital as employer. The theoretical framework is based on a contract theory approach. The empirical data is based on survey data from full-time employed physicians in the medical and surgical divisions in one of the largest university hospitals in Norway. This study shows that perceived obligations and psychological contracts indicate high degree of relational contracts between the hospital and the physicians. These socio-cultural elements should be recognized as important mechanisms of coordination and communication when policy makers and hospital managers are designing hospital management control systems. Copyright © 2009 John Wiley & Sons, Ltd.

  17. Antimicrobial stewardship activities: a survey of Queensland hospitals.

    Science.gov (United States)

    Avent, Minyon L; Hall, Lisa; Davis, Louise; Allen, Michelle; Roberts, Jason A; Unwin, Sean; McIntosh, Kylie A; Thursky, Karin; Buising, Kirsty; Paterson, David L

    2014-11-01

    In 2011, the Australian Commission on Safety and Quality in Health Care (ACSQHC) recommended that all hospitals in Australia must have an Antimicrobial Stewardship (AMS) program by 2013. Nevertheless, little is known about current AMS activities. This study aimed to determine the AMS activities currently undertaken, and to identify gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. The AMS activities of 26 facilities from 15 hospital and health services in Queensland were surveyed during June 2012 to address strategies for effective AMS: implementing clinical guidelines, formulary restriction, reviewing antimicrobial prescribing, auditing antimicrobial use and selective reporting of susceptibility results. The response rate was 62%. Nineteen percent had an AMS team (a dedicated multidisciplinary team consisting of a medically trained staff member and a pharmacist). All facilities had access to an electronic version of Therapeutic Guidelines: Antibiotic, with a further 50% developing local guidelines for antimicrobials. One-third of facilities had additional restrictions. Eighty-eight percent had advice for restricted antimicrobials from in-house infectious disease physicians or clinical microbiologists. Antimicrobials were monitored with feedback given to prescribers at point of care by 76% of facilities. Deficiencies reported as barriers to establishing AMS programs included: pharmacy resources, financial support by hospital management, and training and education in antimicrobial use. Several areas for improvement were identified: reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use. There also appears to be a lack of resources to support AMS programs in some facilities. WHAT IS KNOWN ABOUT THE TOPIC?: The ACSQHC has recommended that all hospitals implement an AMS program by 2013 as a requirement of Standard 3 (Preventing and Controlling Healthcare

  18. Field surveys for the humanization in hospital buildings: tools and case studies

    Directory of Open Access Journals (Sweden)

    Elena Montacchini

    2015-04-01

    Full Text Available The international scientific literature supports the great interest to the evidence-based design, focused on the relationship between the spatial arrangement of hospital environment and the potential support to the healing process. According to this approach, the paper deals with field surveys in hospital departments of oncology; the research is aimed at evaluating the environmental perceived quality by the end users. The analysis carried out through questionnaires and interviews was useful to develop tools for the assessment of the relationship among environmental factors and psycho-emotional reactions and to validate the patients and staff’s needs.

  19. National hospital discharge survey: 2004 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola Jean; DeFrances, Carol Jean; Hall, Margaret Jean

    2006-10-01

    This report presents 2004 national estimates and selected trend data on the use of nonfederal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2004, data were collected for approximately 371,000 discharges. Of the 476 eligible nonfederal short-stay hospitals in the sample, 439 (92 percent) responded to the survey. An estimated 34.9 million inpatients were discharged from nonfederal short-stay hospitals in 2004. They used 167.9 million days of care and had an average length of stay of 4.8 days. Hospital use by age ranged from 4.3 million days of care for patients 5-14 years of age to 31.8 million days of care for 75-84 year olds. Almost a third of patients 85 years and over were discharged from hospitals to long-term care institutions. Diseases of the circulatory system was the leading diagnostic category for males. Childbirth was the leading category for females, followed by circulatory diseases. The proportion of HIV discharges who were 40 years of age and over increased from 40 percent in 1995 to 67 percent in 2004. The rate of cardiac catheterizations was higher for males than for females and higher for patients 65-74 and 75-84 years of age than for older or younger groups. The average length of stay for both vaginal and cesarean deliveries decreased from 1980 through 1995 but stays for vaginal deliveries increased 24 percent during the period from 1995 to 2004.

  20. [The "best" hospitals in the Netherlands; comments on results from the Elsevier survey].

    Science.gov (United States)

    van Everdingen, J J

    2000-12-30

    Health care workers are increasingly asked to disclose the achievements and failures of their medical interventions. Comparative evaluation of hospitals seems to be inevitable. In July 2000 about 6000 health care workers in the Netherlands received a questionnaire from the general lay weekly Elsevier asking them to grade the hospitals in their area: specialists, general practitioners, heads of departments in hospitals, nursing staff and hospital directors. The questionnaire has serious methodological flaws, e.g. regarding the items included (such as 'press sensitivity' and 'waiting lists'), the way in which the score was determined (hospitals that were scored by less than 14 respondents were excluded), the way the questions were formulated (there was no way respondents could indicate their level of experience with the hospitals involved) and the very low response rate (13%). In addition there were no data to determine the accuracy of the questionnaire, the distribution of the respondents, or whether the answers had been adjusted. The questionnaire appears to be primarily aimed at creating sensation. It received little attention in the health care sector, probably because the results were contrary to the expectations. Hospital care will undoubtedly benefit from surveys applying a limited number of well-designed indicators for quality of service, but a questionable public qualification based on a competitive model such as the Elsevier questionnaire will probably do more harm than good.

  1. A survey on postanesthetic patient satisfaction in a university hospital

    Directory of Open Access Journals (Sweden)

    Adel Ali Alshehri

    2015-01-01

    Full Text Available Background and Objectives: Patient satisfaction after anesthesia is an important outcome of hospital care. The aim is to evaluate the postoperative patient satisfaction during the patient stay at King Khalid University Hospital in Riyadh, Saudi Arabia. Patients and Methods: Three hundred and fifty-three patients who underwent surgery under general/regional anesthesia were surveyed. They were interviewed face to face on the first postoperative day. We recorded pain and pain controls in addition to some common complication of anesthesia like nausea and vomiting (postoperative nausea and vomiting as a parameter to assess the rate of patient′s satisfaction. Results: The overall level of satisfaction was high (95.2%; 17 (4.8% patients were dissatisfied with their anesthetic care. There was a strong relation between patient dissatisfaction and: (i Patients with poor postoperative pain control 13 (12.4%, (ii patients with moderate nausea 8 (11.1% and (iii patients with static and dynamic severe pain 6 (21.4. Several factors were associated with dissatisfaction can be prevented, or better treated. Conclusion: We concluded that the patient satisfaction was high. Postoperative visit should be routinely performed in order to assess the quality and severity of postoperative pain, nausea and vomiting and the other side-effects postoperatively.

  2. Surveying hospital nurses to discover educational needs and preferences

    Directory of Open Access Journals (Sweden)

    J. Michael Lindsay

    2017-07-01

    Results: Surveys were completed by 865 respondents, which represented a response rate of 58%. The majority of respondents were registered nurses, licensed practical nurses, and paramedics (81%, and day-shift workers (65%. For education topics, nursing staff placed the highest priority on finding health-related mobile apps for professionals and developing evidence-based research skills. For mode of delivery, respondents expressed a preference for unit-based in-service, computer-based tutorials, and hands-on computer training. Most (70% respondents expressed an interest in participating in a research information skills certificate program. Conclusions: Our survey results reveal an avenue for reinvigorating and updating the library’s educational program to match the needs of nursing staff and may offer valuable insight for other libraries seeking to do the same.  This article has been approved for the Medical Library Association’s Independent Reading Program.

  3. [A Questionnaire Survey on Cooperation between Community Pharmacies and Hospitals in Outpatient Chemotherapy-Comparison of Roles of Pharmacists in Community Pharmacy and Hospitals].

    Science.gov (United States)

    Ishibashi, Masaaki; Ishii, Masakazu; Nagano, Miku; Kiuchi, Yuji; Iwamoto, Sanju

    2018-01-01

     Previous reports suggested that sharing outpatient information during chemotherapy is very important for managing pharmaceutical usage between community pharmacies and hospitals. We herein examined using a questionnaire survey whether pharmaceutical management for outpatient chemotherapy is desired by community and hospital pharmacists. The response rates were 44.3% (133/300) for pharmacists in community pharmacies and 53.7% (161/300) for pharmacists in hospitals. Prescriptions for outpatients during chemotherapy were issued at 88.2% of the hospitals. Currently, 28.9% of hospital pharmacists rarely provide pharmaceutical care, such as patient guidance and adverse effect monitoring, for outpatients receiving oral chemotherapy. Furthermore, whereas 93.7% of hospital pharmacists conducted prescription audits based on the chemotherapy regimen, audits were only performed by 14.8% of community pharmacists. Thus, outpatients, particularly those on oral regimens, were unable to receive safe pharmaceutical care during chemotherapy. Community pharmacists suggested that hospital pharmacists should use "medication notebooks" and disclose prescription information when providing clinical information to community pharmacists. They also suggested sending clinical information to hospital pharmacists by fax. On the other hand, hospital pharmacists suggested the use of "medication notebooks" and electronic medical records when providing clinical information to community pharmacists. In addition, they suggested for community pharmacists to use electronic medical records when providing clinical information to hospital pharmacists. As there may be differences in opinion between community and hospital pharmacists, mutual preliminary communication is important for successful outpatient chemotherapy.

  4. Knowledge and use of evidence-based nutrition : a survey of paediatric dietitians

    NARCIS (Netherlands)

    Thomas, DE; Kukuruzovic, R; Martino, B; Chauhan, SS; Elliott, EJ

    2003-01-01

    Objective To survey paediatric dietitians' knowledge and use of evidence-based nutrition (EBN). Design Cross-sectional survey using reply-paid questionnaires. Subjects Paediatric dietitians in Australian teaching hospitals. Main outcome measures Age, sex, appointment, clinical practice, research

  5. National Hospital Discharge Survey: 2003 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola Jean; Lees, Karen A; DeFrances, Carol J

    2006-05-01

    This report presents 2003 national estimates and trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2003, data were collected for approximately 320,000 discharges. Of the 479 eligible non-Federal short-stay hospitals in the sample, 426 (89 percent) responded to the survey. An estimated 34.7 million inpatients were discharged from non-Federal short-stay hospitals in 2003. They used 167.3 million days of care and had an average length of stay of 4.8 days. Females used almost one-third more days of hospital care than males. Patients with five or more diagnoses rose from 29 percent of discharges in 1990 to 57 percent in 2003. The leading diagnostic category was respiratory diseases for children under 15 years, childbirth for 15-44 year olds, and circulatory diseases for patients 45 years of age and over. Only surgical procedures were performed for 27 percent of discharges, 18 percent had surgical and nonsurgical procedures, and 16 percent had only nonsurgical procedures. A total of 664,000 coronary angioplasties were performed, and stents were inserted during 86 percent of these procedures with drug-eluting stents used in 28 percent. The number and rate of total and primary cesarean deliveries rose from 1995 to 2003. The rate of vaginal birth after cesarean delivery dropped 58 percent, from 35.5 in 1995 to 14.8 in 2003.

  6. Demographic factors and hospital size predict patient satisfaction variance--implications for hospital value-based purchasing.

    Science.gov (United States)

    McFarland, Daniel C; Ornstein, Katherine A; Holcombe, Randall F

    2015-08-01

    Hospital Value-Based Purchasing (HVBP) incentivizes quality performance-based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population-dense areas and could bias Centers for Medicare & Medicaid Services (CMS) reimbursement. Assess nonrandom variation in patient satisfaction as determined by HCAHPS. Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized 4 highly predictive variables, and hospitals were reranked accordingly. A total of 3907 HVBP-participating hospitals. There were 934,800 patient surveys by the most conservative estimate. A total of 3144 county demographics (US Census) and HCAHPS surveys. Hospital size and primary language (non-English speaking) most strongly predicted unfavorable HCAHPS scores, whereas education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals' locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. Demographic and structural factors (eg, hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct. © 2015 Society of Hospital Medicine.

  7. Emission of biocides from hospitals: comparing current survey results with European Union default values.

    Science.gov (United States)

    Tluczkiewicz, Inga; Bitsch, Annette; Hahn, Stefan; Hahn, Torsten

    2010-04-01

    Under the European Union (EU) Biocidal Products Directive 98/8/EC, comprehensive evaluations on substances of the Third Priority List were conducted until 31 July 2007. This list includes, among other categories, disinfectants for human hygiene (e.g., skin and surface disinfection). For environmental exposure assessment of biocides, the EU emission scenarios apply. Currently available default values for disinfectants are based on consumption data from not more than 8 hospitals and were originally assembled for other purposes. To revalidate these default values, a survey on annual consumption data was performed in 27 German hospitals. These data were analyzed to provide consumption data per bed and day and per nurse and day for particular categories of active ingredients and were compared with default values from the EU emission scenario documents. Although several deviations were detected, an overall acceptable correspondence between Emission Scenario Documents default values and the current survey data was found. (c) 2009 SETAC

  8. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital – State

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of the state averages for the HCAHPS survey responses. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...

  9. Watershed-based survey designs

    Science.gov (United States)

    Detenbeck, N.E.; Cincotta, D.; Denver, J.M.; Greenlee, S.K.; Olsen, A.R.; Pitchford, A.M.

    2005-01-01

    Watershed-based sampling design and assessment tools help serve the multiple goals for water quality monitoring required under the Clean Water Act, including assessment of regional conditions to meet Section 305(b), identification of impaired water bodies or watersheds to meet Section 303(d), and development of empirical relationships between causes or sources of impairment and biological responses. Creation of GIS databases for hydrography, hydrologically corrected digital elevation models, and hydrologic derivatives such as watershed boundaries and upstream–downstream topology of subcatchments would provide a consistent seamless nationwide framework for these designs. The elements of a watershed-based sample framework can be represented either as a continuous infinite set defined by points along a linear stream network, or as a discrete set of watershed polygons. Watershed-based designs can be developed with existing probabilistic survey methods, including the use of unequal probability weighting, stratification, and two-stage frames for sampling. Case studies for monitoring of Atlantic Coastal Plain streams, West Virginia wadeable streams, and coastal Oregon streams illustrate three different approaches for selecting sites for watershed-based survey designs.

  10. Association between value-based purchasing score and hospital characteristics

    Directory of Open Access Journals (Sweden)

    Borah Bijan J

    2012-12-01

    Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

  11. Fact-finding survey of nosocomial infection control in hospitals in Vietnam and application to training programs.

    Science.gov (United States)

    Ohara, Hiroshi; Hung, Nguyen Viet; Thu, Truong Anh

    2009-12-01

    Nosocomial infection control is crucial for improving the quality of medical care. It is also indispensable for implementing effective control measures for severe acute respiratory syndrome (SARS) and the possible occurrence of a human influenza pandemic. The present authors, in collaboration with Vietnamese hospital staff, performed a fact-finding survey of nosocomial infection control in hospitals in northern Vietnam and compared the results with those of a survey conducted 4 years previously. Remarkable improvement was recognized in this period, although there were considerable differences between the central hospitals in Hanoi and local hospitals. In the local hospitals, basic techniques and the systems for infection control were regarded as insufficient, and it is necessary to improve these techniques and systems under the guidance of hospitals in the central area. Based on the results of the survey, programs were prepared and training courses were organized in local hospitals. Evaluation conducted after the training courses showed a high degree of satisfaction among the trainees. The results of the survey and the training courses conducted during the study period are expected to contribute to the improvement of nosocomial infection control in remote areas of Vietnam.

  12. Patient satisfaction in out-of-hospital emergency care: a multicentre survey.

    Science.gov (United States)

    Neumayr, Agnes; Gnirke, André; Schaeuble, Joerg C; Ganter, Michael T; Sparr, Harald; Zoll, Adolf; Schinnerl, Adolf; Nuebling, Matthias; Heidegger, Thomas; Baubin, Michael

    2016-10-01

    There is only limited information on patient satisfaction with emergency medical services (EMS). The aim of this multicentre survey was to evaluate patient satisfaction in five out-of-hospital physician-based EMS in Austria and Switzerland. The psychometrically tested and standardized questionnaire 'patient satisfaction in out-of-hospital emergency care' was used for this survey. The recruitment of the patients was carried out on the basis of inclusion and exclusion criteria. All questionnaires were sent together with an invitation letter and a prepaid return envelope, followed by a reminder 2 weeks later. The descriptive statistical analysis was carried out by an external organization to maintain anonymity. The response rate of all EMS was 46.7%. High satisfaction rates were achieved for the four quality scales 'emergency call, emergency treatment, transport and hospital admission'. A significant difference was found between the Swiss and the Austrian dispatch centres in the judgement of the call takers' social skills. Patient satisfaction with the emergency treatment, for example, reduction of pain, was high in all EMS, independent of whether the EMS is physician (Austria) or physician and emergency medical assistant based (Switzerland). Lowest satisfaction rates were found for items of social skills. Patient satisfaction in out-of-hospital physician-based EMS is generally high. There is room for improvement in areas such as the social skills of dispatchers and EMS-team members and the comfort of the patients during transport. A checklist should be developed for basic articles that patients should take along to hospital and for questions on responsibilities for children, dependent people or pets.

  13. [Integration of district psychiatric hospitals into the development of regional community psychiatry networks--the actual state. Results of a survey among medical directors of Bavarian district hospitals].

    Science.gov (United States)

    Welschehold, Michael; Kraus, Eva

    2004-11-01

    In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks ("Gemeindepsychiatrische Verbunde" - GPVs). They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation. An estimation of possible advantages of the hospitals' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: inspite of current heterogenous developments and inspite of existing skepticism concerning the feasibility of a complete GPV structure, medical directors strongly approve of seeing their hospitals actively engaged in the further development of community psychiatry networks.

  14. Quality indicators for the hospital transfusion chain : A national survey conducted in 100 dutch hospitals

    NARCIS (Netherlands)

    Zijlker-Jansen, Pauline Y.; Janssen, M. P.; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.

    2015-01-01

    Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion

  15. Structure analysis of designated hospitals for cancer control in Japan from JASTRO census survey database 2005

    International Nuclear Information System (INIS)

    Ikeda, Hiroshi; Kagami, Yoshikazu; Nishio, Masamichi; Kataoka, Masaaki; Matsumoto, Yasuo; Hatano, Kazuo; Ogino, Takashi

    2008-01-01

    The structures of 288 hospitals designated for cancer control and approved by Ministry of Health, Labour and Welfare in February 2006 were analyzed from radiotherapy aspects according to the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) 2005 census survey data. The data were compiled from 266 hospitals. Overall 78,086 new patients were treated at these designated hospitals, which accounts for just a half the total number of patients in Japan. The structure of radiotherapy (RT) must be essential for cancer management, and our study showed the designated hospitals are insufficient in the RT requirement. No RT equipment is installed in 14 hospitals. Of 266, 109 hospitals treated less than 200 new patients, and 25 hospitals less than 100 in 2005. The data analysis revealed that academic hospitals, JACC hospitals and others are reasonable in terms of structures and capacity of radiotherapy. Moreover, both academic and JACC hospitals play similar roles to designated prefectural hospitals in cancer management by radiotherapy. (author)

  16. A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

    LENUS (Irish Health Repository)

    Naughton, C

    2011-06-01

    Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

  17. Health centres' view of the services provided by a university hospital laboratory: Use of satisfaction surveys

    Science.gov (United States)

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-01-01

    Customer orientation has gained increasing attention in healthcare. A customer satisfaction survey is one way to raise areas and topics for quality improvement. However, it seems that customer satisfaction surveys have not resulted in quality improvement in healthcare. This article reports how the authors' university hospital laboratory has used customer satisfaction surveys targeted at the health centres in their hospital district. Closed-ended statements of the questionnaire were planned to cover the essential aspects of laboratory services. In addition, an open-ended question asked what was considered to be the most important problem in services. The questionnaires were sent to the medical directors of the health centres. The open-ended question proved to be very useful because the responses specified the main problems in service. Based on the responses, selected dissatisfied customers were contacted to specify their responses and possible corrective actions were taken. It is concluded that a satisfaction survey can be used as a screening tool to identify topics of dissatisfaction. In addition, further clarifications with selected customers are needed to specify the causes for their dissatisfaction and to undertake proper corrective actions. PMID:20205616

  18. A survey of pandemic influenza preparedness and response capabilities in Chicago area hospital security departments.

    Science.gov (United States)

    Kimmerly, David P

    2009-01-01

    This article is a summary based on a December 2007 paper prepared by the author in partial fulfillment of the requirements for a master's degree in business and organizational security management at Webster University. The project described was intended to assess Chicago-area healthcare organization security departments' preparedness and response capabilities for a potential influenza pandemic. While the author says healthcare organizations are learning from the pandemics of the past, little research has been conducted on the requirements necessary within hospital security departments. The article explores staffing, planning, preparation and response capabilities within a healthcare security context to determine existing resources available to the healthcare security community. Eleven completed surveys were received from hospital security managers throughout the geographical Chicago area. They reveal that hospital security managers are conscious of the risks of a pandemic influenza outbreak. Yet, it was found that several gaps existed within hospital security department staffing and response capabilities, as hospital security departments may not have the available resources necessary to adequately maintain their operations during a pandemic incident.

  19. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

    Directory of Open Access Journals (Sweden)

    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  20. Internet Hospitals in China: Cross-Sectional Survey.

    Science.gov (United States)

    Xie, Xiaoxu; Zhou, Weimin; Lin, Lingyan; Fan, Si; Lin, Fen; Wang, Long; Guo, Tongjun; Ma, Chuyang; Zhang, Jingkun; He, Yuan; Chen, Yixin

    2017-07-04

    The Internet hospital, an innovative approach to providing health care, is rapidly developing in China because it has the potential to provide widely accessible outpatient service delivery via Internet technologies. To date, China's Internet hospitals have not been systematically investigated. The aim of this study was to describe the characteristics of China's Internet hospitals, and to assess their health service capacity. We searched Baidu, the popular Chinese search engine, to identify Internet hospitals, using search terms such as "Internet hospital," "web hospital," or "cloud hospital." All Internet hospitals in mainland China were eligible for inclusion if they were officially registered. Our search was carried out until March 31, 2017. We identified 68 Internet hospitals, of which 43 have been put into use and 25 were under construction. Of the 43 established Internet hospitals, 13 (30%) were in the hospital informatization stage, 24 (56%) were in the Web ward stage, and 6 (14%) were in full Internet hospital stage. Patients accessed outpatient service delivery via website (74%, 32/43), app (42%, 18/43), or offline medical consultation facility (37%, 16/43) from the Internet hospital. Furthermore, 25 (58%) of the Internet hospitals asked doctors to deliver health services at a specific Web clinic, whereas 18 (42%) did not. The consulting methods included video chat (60%, 26/43), telephone (19%, 8/43), and graphic message (28%, 12/43); 13 (30%) Internet hospitals cannot be consulted online any more. Only 6 Internet hospitals were included in the coverage of health insurance. The median number of doctors available online was zero (interquartile range [IQR] 0 to 5; max 16,492). The median consultation fee per time was ¥20 (approximately US $2.90, IQR ¥0 to ¥200). Internet hospitals provide convenient outpatient service delivery. However, many of the Internet hospitals are not yet mature and are faced with various issues such as online doctor scarcity and

  1. Hospital leadership perspectives on the contributions of Ronald McDonald Houses. Results from an international survey.

    Science.gov (United States)

    Lantz, Paula M; Rubin, Nicole; Mauery, D Richard

    2015-01-01

    The purpose of this paper is to describe an international survey of hospital executives and administrators' perspectives on the contributions of their affiliation with a Ronald McDonald House (RMH) as an example of accommodation in family-centered care to the hospital's mission, operations and patient experience. RMHs worldwide provided the names and e-mail addresses of the people holding key leadership positions in their main hospital partner, who in turn were invited to complete an internet-based survey (530 participants; response rate of 54.5 percent). Hospital leaders reported very positive opinions about the contributions of their RMHs affiliation to their ability to serve seriously ill children and their families. This included such important outcomes as increasing family integrity and family participation in care decisions; and decreasing psychosocial stress and hospital social work resource burdens associated with lodging, food, transportation and sibling support. Hospital chief executive offices (CEOs) and medical directors reported very strong and positive opinions regarding the value-added of their RMHs affiliation in many areas, including enhanced marketing of hospital specialty services and reduced length of stay. Survey response bias is a limitation, although the results are still useful in terms of identifying multiple ways in which RMHs are perceived as contributing to hospitals' operations and provision of family-centered care. Overall, the results suggest that, internationally, hospital leaders believe that RMHs play a key and valued role in their provision of family-centered care to seriously ill children and their families. Family accommodation is more than the simple provision of lodging and plays an integral role how hospitals approach family-centered care. This international study contributes to the general literature on the role of family accommodation in hospitals' provision of family-centered care and the specific and very sparse

  2. Survey of Hospital Employees' Personal Preparedness and Willingness to Work Following a Disaster.

    Science.gov (United States)

    Brice, Jane H; Gregg, David; Sawyer, Dalton; Cyr, Julianne M

    2017-08-01

    Little is known about the personal readiness of hospital staff for disasters. As many as 30% of hospital staff say that they plan not to report for work during a large-scale disaster. We sought to understand the personal disaster preparedness for hospital staff. Surveys were distributed to the staff of a large academic tertiary-care hospital by either a paper-based version distributed through the departmental safety coordinators or a Web-based version distributed through employee e-mail services, depending on employee familiarity with and access to computer services. Surveys assessed the demographic variables and characteristics of personal readiness for disaster. Of the individuals who accessed the survey, 1334 (95.9%) enrolled in it. Women made up 75% of the respondents, with a mean age of 43 years. Respondents had worked at the hospital an average of 9 years, with the majority (90%) being full-time employees. Most households (93%) reported ≤4 members, 6% supported a person with special medical needs, and 17% were headed by a single parent. A small number (24%) of respondents reported an established meeting place for reuniting households during a disaster. Many reported stockpiling a 3-day supply of food (86%) and a 3-day supply of water (51%). Eighteen percent of respondents were not aware of workplace evacuation plans. Most respondents were willing to report to work for natural disasters (eg, tornado, snowstorm; all categories >65%), but fewer respondents were willing to report during events such as an influenza epidemic (54%), a biological outbreak (41%), a chemical exposure, (40%), or a radiation exposure (39%). Multivariate analysis revealed being female, having a child in the household younger than 6 years old, and having a child in school lowered the likelihood of being willing to report to work in two or more event types, whereas pet ownership, being a clinical healthcare worker, and being familiar with the work emergency plan increased the likelihood

  3. American Samoa Shore-based Creel Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The DMWR staff has also conducted shore-based creel surveys which also have 2 major sub-surveys; one to estimate participation (fishing effort), and one to provide...

  4. Workforce perceptions of hospital safety culture: development and validation of the patient safety climate in healthcare organizations survey.

    Science.gov (United States)

    Singer, Sara; Meterko, Mark; Baker, Laurence; Gaba, David; Falwell, Alyson; Rosen, Amy

    2007-10-01

    To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's alpha coefficients ranged from 0.50 to 0.89. It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes.

  5. A survey of rural hospitals' perspectives on health information technology outsourcing.

    Science.gov (United States)

    Johnson, Nicholas; Murphy, Alison; McNeese, Nathan; Reddy, Madhu; Purao, Sandeep

    2013-01-01

    A survey of rural hospitals was conducted in the spring of 2012 to better understand their perspectives on health information technology (HIT) outsourcing and the role that hospital-to-hospital HIT partnerships (HHPs) can play as an outsourcing mechanism. The survey sought to understand how HHPs might be leveraged for HIT implementation, as well as the challenges with forming them. The results suggest that HHPs have the potential to address rural hospitals' slow rate of HIT adoption, but there are also challenges to creating these partnerships. These issues, as well as avenues for further research, are then discussed.

  6. Hospital clinicians' information behaviour and attitudes towards the 'Clinical Informationist': an Irish survey.

    LENUS (Irish Health Repository)

    Flynn, Maura G

    2012-02-01

    BACKGROUND: Hospital clinicians are increasingly expected to practice evidence-based medicine (EBM) in order to minimize medical errors and ensure quality patient care, but experience obstacles to information-seeking. The introduction of a Clinical Informationist (CI) is explored as a possible solution. AIMS: This paper investigates the self-perceived information needs, behaviour and skill levels of clinicians in two Irish public hospitals. It also explores clinicians\\' perceptions and attitudes to the introduction of a CI into their clinical teams. METHODS: A questionnaire survey approach was utilised for this study, with 22 clinicians in two hospitals. Data analysis was conducted using descriptive statistics. RESULTS: Analysis showed that clinicians experience diverse information needs for patient care, and that barriers such as time constraints and insufficient access to resources hinder their information-seeking. Findings also showed that clinicians struggle to fit information-seeking into their working day, regularly seeking to answer patient-related queries outside of working hours. Attitudes towards the concept of a CI were predominantly positive. CONCLUSION: This paper highlights the factors that characterise and limit hospital clinicians\\' information-seeking, and suggests the CI as a potentially useful addition to the clinical team, to help them to resolve their information needs for patient care.

  7. The Aalborg Survey / Part 3 - Interview Based Survey

    DEFF Research Database (Denmark)

    Harder, Henrik; Christensen, Cecilie Breinholm; Jensen, Maria Vestergaard

    Background and purpose The Aalborg Survey consists of four independent parts: a web, GPS and an interview based survey and a literature study, which together form a consistent investigation and research into use of urban space, and specifically into young people’s use of urban space: what young...... people do in urban spaces, where they are in the urban spaces and when the young people are in the urban spaces. The answers to these questions form the framework and enable further academic discussions and conclusions in relation to the overall research project Diverse Urban Spaces (DUS). The primary......) and the research focus within the cluster of Mobility and Tracking Technologies (MoTT), AAU. Summary / Part 3 - Interview Based Survey The 3rd part of the DUS research project has been carried out during the fall of 2009 and the summer and fall of 2010 as an interview based survey of 18 selected participants (nine...

  8. The European surveillance of antimicrobial consumption (ESAC) point-prevalence survey of antibacterial use in 20 European hospitals in 2006.

    Science.gov (United States)

    Ansari, Faranak; Erntell, Mats; Goossens, Herman; Davey, Peter

    2009-11-15

    Point-prevalence surveys have been used to document antimicrobial use in hospitals for >20 years. However, published surveys are inconsistent with respect to population, indication, and the details of therapy that were included. We aimed to standardize a method for surveillance of antibacterial use in hospitals from different health care systems and to identify targets for quality improvement. We adapted a Web-based reporting system from STRAMA, the Swedish Strategic Programme against antibiotic resistance. One hospital from each of 20 countries took part in the survey, which was completed during 2 calendar weeks during 1 April 2006 through 31 May 2006. The survey included all inpatient beds for adults and children and identified all patients who were receiving systemic antibacterial treatments on the day of survey and all patients who had received antibacterial prophylaxis for surgery on the previous day. On the day of survey there were 11,571 inpatients in the 20 participating hospitals, of whom 30.1% were receiving antibacterial treatment (range, 19%-59%). The most common anatomic sites of infection for which antibacterials were prescribed were respiratory tract (24%); skin, bone, and joint (18%); intra-abdominal organs (16%); and urinary tract (11%). The following 3 quality indicators were identified: indication documented in case notes (64%), prophylaxis for surgery not continued for >24 h (60%), and therapy for community-acquired pneumonia not including third-generation cephalosporins or quinolones (78.5%). A Web-based method for a point-prevalence survey was successfully piloted in 20 hospitals across Europe and offers a standardized instrument that can identify targets for quality improvement.

  9. Survey of sterile admixture practices in canadian hospital pharmacies: part 2. More results and discussion.

    Science.gov (United States)

    Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

    2009-05-01

    The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its "General Chapter Pharmaceutical Compounding-Sterile Preparations", which set a more rigorous and enforceable standard for sterile compounding in the United States. To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter standards. An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter standards, was created and distributed to 193 Canadian hospital pharmacies. A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. The survey methods for this study and results relating to policies, personnel, raw materials, storage and handling, facilities and

  10. Survey of sterile admixture practices in canadian hospital pharmacies: part 1. Methods and results.

    Science.gov (United States)

    Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

    2009-03-01

    The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its "General Chapter Pharmaceutical Compounding-Sterile Preparations", which set a more rigorous and enforceable standard for sterile compounding in the United States. To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter standards. An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter standards, was created and distributed to 193 Canadian hospital pharmacies. A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. Part 1 of this series reports the survey methods and results relating to policies, personnel, raw materials, storage and handling

  11. Drug and Therapeutics (D & T) committees in Dutch hospitals : a nation-wide survey of structure, activities, and drug selection procedures

    NARCIS (Netherlands)

    Fijn, R; Brouwers, JRBJ; Knaap, RJ; De Jong-Van den Berg, LTW

    Aims To determine structure, activities and drug selection processes used by Dutch hospital drug and therapeutics (D & T) committees. Methods A pretested structured survey questionnaire based on the Australian process and impact indicators, previous research, and consultation of professionals was

  12. Errors and omissions in hospital prescriptions: a survey of prescription writing in a hospital.

    Science.gov (United States)

    Calligaris, Laura; Panzera, Angela; Arnoldo, Luca; Londero, Carla; Quattrin, Rosanna; Troncon, Maria G; Brusaferro, Silvio

    2009-05-13

    The frequency of drug prescription errors is high. Excluding errors in decision making, the remaining are mainly due to order ambiguity, non standard nomenclature and writing illegibility. The aim of this study is to analyse, as a part of a continuous quality improvement program, the quality of prescriptions writing for antibiotics, in an Italian University Hospital as a risk factor for prescription errors. The point prevalence survey, carried out in May 26-30 2008, involved 41 inpatient Units. Every parenteral or oral antibiotic prescription was analysed for legibility (generic or brand drug name, dose, frequency of administration) and completeness (generic or brand name, dose, frequency of administration, route of administration, date of prescription and signature of the prescriber). Eight doctors (residents in Hygiene and Preventive Medicine) and two pharmacists performed the survey by reviewing the clinical records of medical, surgical or intensive care section inpatients. The antibiotics drug category was chosen because its use is widespread in the setting considered. Out of 756 inpatients included in the study, 408 antibiotic prescriptions were found in 298 patients (mean prescriptions per patient 1.4; SD +/- 0.6). Overall 92.7% (38/41) of the Units had at least one patient with antibiotic prescription. Legibility was in compliance with 78.9% of generic or brand names, 69.4% of doses, 80.1% of frequency of administration, whereas completeness was fulfilled for 95.6% of generic or brand names, 76.7% of doses, 83.6% of frequency of administration, 87% of routes of administration, 43.9% of dates of prescription and 33.3% of physician's signature. Overall 23.9% of prescriptions were illegible and 29.9% of prescriptions were incomplete. Legibility and completeness are higher in unusual drugs prescriptions. The Intensive Care Section performed best as far as quality of prescription writing was concerned when compared with the Medical and Surgical Sections

  13. Student Opinions about the Seven-Step Procedure in Problem-Based Hospitality Management Education

    Science.gov (United States)

    Zwaal, Wichard; Otting, Hans

    2014-01-01

    This study investigates how hospitality management students appreciate the role and application of the seven-step procedure in problem-based learning. A survey was developed containing sections about personal characteristics, recall of the seven steps, overall report marks, and 30 statements about the seven-step procedure. The survey was…

  14. Staffing for infectious diseases, clinical microbiology and infection control in hospitals in 2015: results of an ESCMID member survey.

    Science.gov (United States)

    Dickstein, Y; Nir-Paz, R; Pulcini, C; Cookson, B; Beović, B; Tacconelli, E; Nathwani, D; Vatcheva-Dobrevska, R; Rodríguez-Baño, J; Hell, M; Saenz, H; Leibovici, L; Paul, M

    2016-09-01

    We aimed to assess the current status of infectious diseases (ID), clinical microbiology (CM) and infection control (IC) staffing in hospitals and to analyse modifiers of staffing levels. We conducted an Internet-based survey of European Society of Clinical Microbiology and Infectious Diseases members and affiliates, collecting data on hospital characteristics, ID management infrastructure, ID/IC-related activities and the ratio of physicians per 100 hospital beds. Regression analyses were conducted to examine factors associated with the physician-bed ratio. Five hundred sixty-seven hospital responses were collected between April and June 2015 from 61 countries, 81.2% (384/473) from Europe. A specialized inpatient ward for ID patients was reported in 58.4% (317/543) of hospitals. Rates of antibiotic stewardship programmes (ASP) and surveillance activities in survey hospitals were high, ranging from 88% to 90% for local antibiotic guidelines and 70% to 82% for programmes monitoring hospital-acquired infections. The median ID/CM/IC physician per 100 hospital beds ratio was 1.12 (interquartile range 0.56-2.13). In hospitals performing basic ASP and IC (including local antibiotic guidelines and monitoring device-related or surgical site infections), the ratio was 1.21 (interquartile range 0.57-2.14). Factors independently associated with higher ratios included compliance with European Union of Medical Specialists standards, smaller hospital size, tertiary-care institution, presence of a travel clinic, beds dedicated to ID and a CM unit. More than half of respondents estimated that additional staffing is needed for appropriate IC or ID management. No standard of physician staffing for ID/CM/IC in hospitals is available. A ratio of 1.21/100 beds will serve as an informed point of reference enabling ASP and infection surveillance. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Internet usage and potential impact for acute care hospitals: survey in the United States.

    Science.gov (United States)

    Hatcher, M

    1998-12-01

    These survey results are from a national survey of acute care hospitals. A random sample of 813 hospitals was selected with 115 responding and 33 incorrect addresses resulting in a 15% response rate. The purpose of the study was to measure the extent of information systems integration in the financial, medical, and administrative systems of the hospitals. Internet usage including homepages and advertising was measured. Other selected telecommunication applications are analyzed. As demonstration projects from the literature are compared to the survey results, the potential for hospitals is tremendous. Resulting cost savings could be equally impressive. This information will provide a benchmark for hospitals to determine their position relative to Internet technology and to set goals.

  16. Lifestyle behaviours and weight among hospital-based nurses.

    Science.gov (United States)

    Zapka, Jane M; Lemon, Stephenie C; Magner, Robert P; Hale, Janet

    2009-11-01

    The purpose of this study was to (i) describe the weight, weight-related perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore the relationship of demographic, health, weight and job characteristics with lifestyle behaviours. The obesity epidemic is widely documented. Worksite initiatives have been advocated. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients. A sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys. The majority of nurses were overweight and obese, and some were not actively involved in weight management behaviours. Self-reported health, diet and physical activity behaviours were low, although variable by gender, age and shift. Reports of co-worker norms supported low levels of healthy behaviours. Findings reinforce the need to address the hospital environment and culture as well as individual behaviours for obesity control. Nurse managers have an opportunity to consider interventions that promote a climate favourable to improved health habits by facilitating and supporting healthy lifestyle choices (nutrition and physical activity) and environmental changes. Such efforts have the potential to increase productivity and morale and decrease work-related disabilities and improve quality of life.

  17. Department of Defense TRICARE Inpatient Satisfaction Survey (TRISS) Data– military hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file contains U.S. military hospital data from the TRICARE Inpatient Satisfaction Survey (TRISS) administered by the Department of Defense (DoD). TRISS data do...

  18. Management of chronic orofacial pain: a survey of general dentists in german university hospitals

    NARCIS (Netherlands)

    Wirz, Stefan; Ellerkmann, Richard K.; Buecheler, Marcus; Putensen, Christian; Nadstawek, Joachim; Wartenberg, Hans-Christian

    2010-01-01

    AIM: This survey assessed procedures performed by general dentists in German university hospitals treating patients with chronic orofacial pain (COP). METHODS: A standardized questionnaire was sent to dentists at all 42 German universities. Doctors were asked to describe demographics, diagnoses,

  19. Ranking hospitals for outcomes in total hip replacement - administrative data with or without patient surveys? - Part 2: Patient survey and administrative data

    Directory of Open Access Journals (Sweden)

    Schäfer, Thomas

    2007-03-01

    Full Text Available Background: Many hospital rankings rely on the frequency of adverse outcomes and are based on administrative data. In the study presented here, we tried to find out, to what extent available administrative data of German Sickness Funds allow for an adequate hospital ranking and compared this with rankings based on additional information derived from a patient survey. Total hip replacement was chosen as an example procedure. In part II of the publication, we present the results of the approach based on administrative and patient-derived data. Methods: We used administrative data from a large health insurance (AOK-Lower Saxony of the year 2002 and from a patient survey. The study population comprised mainly beneficiaries, who received primary total hip replacement in the year 2002, were mailed a survey 6 month post-operatively and participated in the survey. Performance indicators used where “Revision”, “Complications” and “Change of functional impairment”. Hospitals were ranked if they performed at least 20 procedures on AOK-beneficiaries. Multivariate modelling (logistic regression and generalized linear models was used to estimate the performance indicators by case-mix variables (a.o. age, sex, co-morbidity, medical history and hospital characteristics (hospital size, surgical volume. The actual ranking was based on these multivariate models, excluding hospital variables and adding dummy-variables for each hospital. Hospitals were ranked by their case-mix adjusted odds ratio or Standardized Difference (SDR with respect to a pre-selected reference hospital. The resulting rankings were compared with each other and with regard to the impact of case-mix variables. Results: 4089 beneficiaries received primary total hip replacement in 2002. 3293 patients participated in the survey (80.5%. The ranking included 60 hospitals. The agreement of rankings based on different performance indicators in the same year was low to high (a correlation

  20. The utilization of activity-based cost accounting in hospitals.

    Science.gov (United States)

    Emmett, Dennis; Forget, Robert

    2005-01-01

    Healthcare costs are being examined on all fronts. Healthcare accounts for 11% of the gross national product and will continue to rise as the "babyboomers" reach retirement age. While ascertaining costs is important, most research shows that costing methods have not been implemented in hospitals. This study is concerned with the use of costing methods; particularly activity-based cost accounting. A mail survey of CFOs was undertaken to determine the type of cost accounting method they use. In addition, they were asked whether they were aware of activity-based cost accounting and whether they had implemented it or were planning to implement it. Only 71.8% were aware of it and only 4.7% had implemented it. In addition, only 52% of all hospitals report using any cost accounting systems. Education needs to ensure that all healthcare executives are cognizant of activity-based accounting and its importance in determining costs. Only by determining costs can hospitals strive to contain them.

  1. Tactical hospital marketing: a survey of the state of the art.

    Science.gov (United States)

    McDevitt, P K; Shields, L A

    1985-01-01

    This paper reports the results of a survey of acute care hospitals which was undertaken to: (1) identify and establish the organizational positioning of key hospital marketing personnel; (2) measure the role of these personnel in influencing the traditional marketing mix decisions; and, (3) identify tactical marketing activities most frequently undertaken.

  2. Hospitalization in Parkinson disease: a survey of National Parkinson Foundation Centers

    NARCIS (Netherlands)

    Chou, K.L.; Zamudio, J.; Schmidt, P.; Price, C.C.; Parashos, S.A.; Bloem, B.R.; Lyons, K.E.; Christine, C.W.; Pahwa, R.; Bodis-Wollner, I.; Oertel, W.H.; Suchowersky, O.; Aminoff, M.J.; Malaty, I.A.; Friedman, J.H.; Okun, M.S.

    2011-01-01

    OBJECTIVES: To explore current practices and opinions regarding hospital management of Parkinson disease (PD) patients in specialized PD Centers. METHODS: Fifty-one out of 54 National Parkinson Foundation (NPF) Centers worldwide completed an online survey regarding hospitalization of PD patients.

  3. National Survey of Environmental Cleaning and Disinfection in Hospitals in Thailand.

    Science.gov (United States)

    Apisarnthanarak, Anucha; Weber, David J; Ratz, David; Saint, Sanjay; Khawcharoenporn, Thana; Greene, M Todd

    2017-10-01

    More than 90% of Thai hospitals surveyed reported implementing environmental cleaning and disinfection (ECD) protocols. Hospital epidemiologist presence was associated with the existence of an ECD checklist (P=.01) and of ECD auditing (P=.001), while good and excellent hospital administrative support were associated with better adherence to ECD protocols (P<.001) and ECD checklists (P=.005). Infect Control Hosp Epidemiol 2017;38:1250-1253.

  4. Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.

    Science.gov (United States)

    Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B

    2018-01-29

    Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings

  5. Arduino based radiation survey meter

    International Nuclear Information System (INIS)

    Rahman, Nur Aira Abd; Lombigit, Lojius; Abdullah, Nor Arymaswati; Azman, Azraf; Dolah, Taufik; Jaafar, Zainudin; Mohamad, Glam Hadzir Patai; Ramli, Abd Aziz Mhd; Zain, Rasif Mohd; Said, Fazila; Khalid, Mohd Ashhar; Taat, Muhamad Zahidee; Muzakkir, Amir

    2016-01-01

    This paper presents the design of new digital radiation survey meter with LND7121 Geiger Muller tube detector and Atmega328P microcontroller. Development of the survey meter prototype is carried out on Arduino Uno platform. 16-bit Timer1 on the microcontroller is utilized as external pulse counter to produce count per second or CPS measurement. Conversion from CPS to dose rate technique is also performed by Arduino to display results in micro Sievert per hour (μSvhr −1 ). Conversion factor (CF) value for conversion of CPM to μSvhr −1 determined from manufacturer data sheet is compared with CF obtained from calibration procedure. The survey meter measurement results are found to be linear for dose rates below 3500 µSv/hr

  6. Arduino based radiation survey meter

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, Nur Aira Abd, E-mail: nur-aira@nm.gov.my; Lombigit, Lojius; Abdullah, Nor Arymaswati; Azman, Azraf; Dolah, Taufik; Jaafar, Zainudin; Mohamad, Glam Hadzir Patai; Ramli, Abd Aziz Mhd; Zain, Rasif Mohd; Said, Fazila; Khalid, Mohd Ashhar; Taat, Muhamad Zahidee [Malaysian Nuclear Agency, 43000, Bangi, Selangor (Malaysia); Muzakkir, Amir [Sinaran Utama Teknologi Sdn Bhd, 43650, Bandar Baru Bangi, Selangor (Malaysia)

    2016-01-22

    This paper presents the design of new digital radiation survey meter with LND7121 Geiger Muller tube detector and Atmega328P microcontroller. Development of the survey meter prototype is carried out on Arduino Uno platform. 16-bit Timer1 on the microcontroller is utilized as external pulse counter to produce count per second or CPS measurement. Conversion from CPS to dose rate technique is also performed by Arduino to display results in micro Sievert per hour (μSvhr{sup −1}). Conversion factor (CF) value for conversion of CPM to μSvhr{sup −1} determined from manufacturer data sheet is compared with CF obtained from calibration procedure. The survey meter measurement results are found to be linear for dose rates below 3500 µSv/hr.

  7. Information Sharing, Cooperative Behaviour and Hotel Performance: A Survey of the Kenyan Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Sammy Odari Namusonge

    2015-10-01

    Full Text Available Information sharing is the life blood of supply chain collaboration. Its role in achieving operational performance of supply chains has been widely acclaimed. However whether information sharing would result in improved performance in the context of the hospitality industry has not been empirically determined. This study sought to find out the role of information sharing on hotel performance when the relationship was mediated by cooperative behaviour. A survey design was employed where proportionate stratified sampling was used to select 50 out of 57 town hotels. Data was collected through the use of questionnaires as well interview guides to the procurement\\supply chain departments of these hotels. Logarithmic transformations were used in conjunction with multiple regression analysis to determine the relationship between information sharing, cooperative behaviour and hotel performance. The study concludes that information sharing in the Kenyan hospitality industry does not directly relate to hotel performance. Its relationship is mediated by cooperative behaviour (trust and attitude with supply chain partners. This suggests that information sharing is essential but insufficient by itself to bring significant performance improvements in hotels in the Kenyan hospitality industry. A possible reason for this is that this collaborative practice is highly dependent on information sharing capability, structure of the information as well as culture. Through quadrant analysis the study identifies and recommends the sharing of information about long term strategic plans and events such as entering new markets and acquiring a new customer base as an area of primary priority for improvement.

  8. Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital

    Directory of Open Access Journals (Sweden)

    Colin Lee

    2015-06-01

    Conclusion: This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.

  9. The relationship between transformational leadership and social capital in hospitals--a survey of medical directors of all German hospitals.

    Science.gov (United States)

    Hammer, Antje; Ommen, Oliver; Röttger, Julia; Pfaff, Holger

    2012-01-01

    The German hospital market has been undergoing major changes in recent years. Success in this new market is determined by a multitude of factors. One is the quality of the social relationships between staff and the presence of shared values and rules. This factor can be considered an organization's "social capital." This study investigates the relationship between social capital and leadership style in German hospitals using a written survey of medical directors. In 2008, a cross-sectional representative study was conducted with 1224 medical directors from every hospital in Germany with at least 1 internal medicine unit and 1 surgery unit. Among the scales included in the standardized questionnaire were scales used to assess the medical directors' evaluation of social capital and transformational leadership in the hospital. We used a multiple linear regression model to examine the relationship between social capital and internal coordination. We controlled for hospital ownership, teaching status, and number of beds. In total, we received questionnaires from 551 medical directors, resulting in a response rate of 45.2%. The participating hospitals had an average of 345 beds. The sample included public (41.3%), not-for-profit (46.9%), and for-profit (11.7%) hospitals. The data, which exclusively represent the perceptions of the medical directors, indicate a significant correlation between a transformational leadership style of the executive management and the social capital as perceived by medical directors. A transformational leadership style of the executive management accounted for 36% of variance of the perceived social capital. The perceived social capital in German hospitals is closely related to the leadership style of the executive management. A transformational leadership style of the executive management appears to successfully strengthen the hospital's social capital.

  10. ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2011.

    Science.gov (United States)

    Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

    2012-05-01

    Results of the 2011 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. A stratified random sample of pharmacy directors at 1401 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 40.1%. Decentralization of the medication-use system continues, with 40% of hospitals using a decentralized system and 58% of hospitals planning to use a decentralized model in the future. Automated dispensing cabinets were used by 89% of hospitals, robots were used by 11%, carousels were used in 18%, and machine-readable coding was used in 34% of hospitals to verify doses before dispensing. Overall, 65% of hospitals had a United States Pharmacopeia chapter 797 compliant cleanroom for compounding sterile preparations. Medication administration records (MARs) have become increasingly computerized, with 67% of hospitals using electronic MARs. Bar-code-assisted medication administration was used in 50% of hospitals, and 68% of hospitals had smart infusion pumps. Health information is becoming more electronic, with 67% of hospitals having partially or completely implemented an electronic health record and 34% of hospitals having computerized prescriber order entry. The use of these technologies has substantially increased over the past year. The average number of full-time equivalent staff per 100 occupied beds averaged 17.5 for pharmacists and 15.0 for technicians. Directors of pharmacy reported declining vacancy rates for pharmacists. Pharmacists continue to improve medication use at the dispensing and administration steps of the medication-use system. The adoption of new technology is changing the philosophy of medication distribution, and health information is rapidly becoming electronic.

  11. Survey of the Information-Seeking Behaviour of Hospital Professionals at a Public Cancer Hospital in Greece Proves the Value of Hospital Libraries. A Review of: Kostagiolas, P. A., Ziavrou, K., Alexias, G., & Niakas, D. (2012. Studying the information-seeking behavior of hospital professionals: The case of METAXA Cancer Hospital in Greece. Journal of Hospital Librarianship, 12(1, 33-45.

    Directory of Open Access Journals (Sweden)

    Antonio DeRosa

    2013-06-01

    time (3.7 score on Likert scale. A lack of information services was second to the time issue with a Likert scale score of 3.6.Conclusion – Based on the research results, the authors affirmed the invaluable role of hospital libraries. The hospital library can help to eliminate the obstacles faced by healthcare professionals by providing support in the areas of weakness based on the survey results. This can be made possible through the hospital library’s involvement in educational activities, investigation of information technologies, and development of information services to accommodate the difficulties regularly experienced by hospital staff. Researchers revealed that funding for hospital libraries in Greece is an issue preventing many new initiatives, that there is no association to represent hospital libraries in Greece, that the few libraries operating in hospitals in Greece are understaffed with no administrative control, and the majority of Greek hospitals do not have adequate library facilities. These drawbacks contribute to the information-seeking challenges experienced by Greek healthcare professionals.

  12. The Aalborg Survey / Part 1 - Web Based Survey

    DEFF Research Database (Denmark)

    Harder, Henrik; Christensen, Cecilie Breinholm

    Background and purpose The Aalborg Survey consists of four independent parts: a web, GPS and an interview based survey and a literature study, which together form a consistent investigation and research into use of urban space, and specifically into young people’s use of urban space: what young......) and the research focus within the cluster of Mobility and Tracking Technologies (MoTT), AAU. Summary / Part 1 Web Base Survey The 1st part of the research project Diverse Urban Spaces (DUS) has been carried out during the period from December 1st 2007 to February 1st 2008 as a Web Based Survey of the 27.040 gross...... [statistikbanken.dk, a] young people aged 14-23 living in Aalborg Municipality in 2008. The web based questionnaire has been distributed among the group of young people studying at upper secondary schools in Aalborg, i.e. 7.680 young people [statistikbanken.dk, b]. The resulting data from those respondents who...

  13. Multi-centre point prevalence survey of hospital-acquired infections in Ghana.

    Science.gov (United States)

    Labi, Appiah-Korang; Obeng-Nkrumah, Noah; Owusu, Enid; Bjerrum, Stephanie; Bediako-Bowan, Antoinette; Sunkwa-Mills, Gifty; Akuffo, Christiana; Fenny, Ama Pokua; Opintan, Japheth Awuletey; Enweronu-Laryea, Christabel; Debrah, Samuel; Damale, Nelson; Bannerman, Cynthia; Newman, Mercy Jemima

    2018-05-03

    There is a paucity of data describing hospital acquired infections (HAIs) in Africa. To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. Between September and December 2016, point prevalence surveys were conducted in participating hospitals using protocols of the European Centre for Disease Prevention and Control. We reviewed medical records of eligible inpatients at or before 8am on the day of survey to identify HAIs present at the time of survey. Ten hospitals were surveyed, representing 32.9% of all acute care beds in government hospitals. Of 2107 inpatients surveyed, 184 HAIs were identified among 172 patients, corresponding to an overall prevalence of 8.2%. The prevalence values in hospitals ranged from 3.5 to 14.4% with higher proportion of infections in secondary and tertiary care facilities. The most frequent HAIs were surgical site infections (32.6%), bloodstream infections (19.5%), urinary tract infections (18.5%), and respiratory tract infections (16.3%). Device-associated infections accounted for 7.1% of HAIs. For 12.5% of HAIs, a microorganism was reported; the most isolated microorganism was Escherichia coli. Approximately 61% of all patients surveyed were on antibiotics; 89.5% of patients with an HAI received at least one antimicrobial agent on the day of survey. The strongest independent predictors for HAI were the presence of invasive device before onset of infection and duration of hospital stay. We recorded a low HAI burden compared to findings from other low and middle income countries. Copyright © 2018. Published by Elsevier Ltd.

  14. Assessing the magnitude and trends in hospital acquired infections in Canadian hospitals through sequential point prevalence surveys

    Directory of Open Access Journals (Sweden)

    Geoffrey Taylor

    2016-05-01

    Full Text Available Abstract Background Healthcare acquired infections (HAI are an important public health problem in developed countries, but comprehensive data on trends over time are lacking. Prevalence surveys have been used as a surrogate for incidence studies and can be readily repeated. Methods The Canadian Nosocomial Infection Surveillance Program conducted prevalence surveys in 2002 and 2009 in a large network of major Canadian acute care hospitals. NHSN definitions of HAI were used. Use of isolation precautions on the survey day was documented. Results In 2009, 9,953 acute care inpatients were surveyed; 1,234 infections (124/1000 were found, compared to 111/1000 in 2002, (p < 0.0001. There was increased prevalence of urinary tract infection (UTI and Clostridium difficile, offset by decreases in pneumonia and bloodstream infection. Use of isolation precautions increased from 77 to 148 per 1000 patients (p < 0.0001, attributable to increased use of contact precautions in patients infected or colonized with antimicrobial resistant organisms. Conclusion Between 2002 and 2009 HAI prevalence increased by 11.7 % in a network of major Canadian hospitals due to increases in Clostridium difficile and urinary tract infection. The use of isolation precautions increased by 92.2 % attributable to increased contact isolation. National prevalence surveys are useful tools to assess evolving trends in HAI.

  15. A Survey of Job Satisfaction among Midwives Working in Hospitals

    Directory of Open Access Journals (Sweden)

    Fariba Khavayet

    2018-01-01

    Full Text Available Background & aim: Job satisfaction is one of the important factors enhancing organizational efficiency and employees' performance. This study aimed to evaluate job satisfaction among midwives working in hospitals. Methods: This cross-sectional study included all midwives (N=100 working in hospitals affiliated to Abadan School of Medical Sciences, Abadan, Iran in 2016. To obtain data, we used a demographic as well as Herzberg's Job Satisfaction Questionnaire with α=0.96 in Iran. To analyze the data, independent t-test, Chi-square test, and Pearson correlation coefficient were run in SPSS, version 22. Results: The mean age and work experience of the subjects were 35.37±7.3 and 11.23±7.8 years, respectively. The mean job satisfaction score of the midwives was 302.41±19. The results showed that the subjects had moderate job satisfaction in the eight domains of occupational nature and position (48%, job security (46%, salary and benefits (61%, occupational and environmental conditions (90%, relationship with colleagues (87%, supervision (91%, management policy-making (80%, and personal relationships (85%. There was a significant correlation between work experience and job satisfaction, while there was no significant relationship between job satisfaction and other demographic variables. Conclusion: Considering the moderate level of job satisfaction among the midwives working in the hospitals affiliated to Abadan School of Medical Sciences, authorities should take effective steps to address job dissatisfaction by promoting occupational security, creating professional standards, and using midwives’ capabilities in building appropriate relationships with colleagues.

  16. A Survey of Acute Pain Service Structure and Function in United States Hospitals

    Directory of Open Access Journals (Sweden)

    Dawood Nasir

    2011-01-01

    Full Text Available Although the number of U.S. hospitals offering an acute pain service (APS is increasing, the typical structure remains unknown. This survey was undertaken to describe the structure and function of the APS in U.S. hospitals only. We contacted 200 non-teaching and 101 teaching U.S. hospitals. The person in charge of postoperative pain management completed and returned the survey. Seventy-four percent of responding hospitals had an organized APS. An APS was significantly more formally organized in academic/teaching hospitals when compared to non-teaching hospitals. Pain assessments included “pain at rest” (97%, “pain on activity” (63%, and reassessment after pain therapy intervention (88.8%. Responding hospitals utilized postoperative pain protocols significantly more commonly in teaching hospitals when compared to non-teaching and VA hospitals. Intravenous patient controlled analgesia (IV-PCA was managed most commonly by surgeons (75%, while epidural analgesia and peripheral nerve block infusions were exclusively managed by anesthesiologists. For improved analgesia, 62% allowed RNs to adjust the IV-PCA settings within set parameters, 43% allowed RN adjustment of epidural infusion rates, and 21% allowed RN adjustment of peripheral nerve catheter local anesthetic infusion rates.

  17. A survey of four years intrauterine insemination at Shariati Hospital

    Directory of Open Access Journals (Sweden)

    Aghahosseini M

    1998-08-01

    Full Text Available Intrauterine insemination (IUI has been practiced since the late 1800's primarily for idiopathic infertility, and in men with deficient semen parameters. The procedure is done by placing washed sperm in uterus a few hours before ovulation. The records of 427 couples receiving IUI for treatment of infertility at Shariati hospital in 1370-74 were reviewed retrospectively. These patients had IUI in 574 cycles. Eighty patients became pregnant and delivery rate was 14% per cycle. Pregnancy rate is impressive when ovulation induction is combined with insemination timed just before ovulation. The success rate in Shariati hospital is comparable to other infertility centers in the world and cost of a cycle of IUI with HMG superovulation is approximately one third the cost of IVF-ET or GIFT cycle and avoids invasive oocyte retrieval and extracorporeal fertilization. So we suggest that women with refractory infertility without anatomic distortion of pelvis can have at least 3-6 cycles of IUI before IVF or GIFT.

  18. Radiation Protection in Pediatric Radiology: Results of a Survey Among Dutch Hospitals.

    Science.gov (United States)

    Bijwaard, Harmen; Valk, Doreth; de Waard-Schalkx, Ischa

    2016-10-01

    A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children's hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children's hospitals but also between the respective general and children's hospitals. It is recommended that hospitals consult each other to come up with more uniform best practices. Few hospitals were able to supply doses that can be compared to the national Diagnostic Reference Levels (DRLs). The ones that could be compared exceeded the DRLs in one in five cases, which is more than was expected beforehand.

  19. INFRASTRUCTURAL MECHANISMS LEADING TOWARD PRO-ACCOUNTABLE CARE ORGANISATION ORIENTATION: A SURVEY OF HOSPITAL MANAGERS

    Science.gov (United States)

    Wan, Thomas T.H.; Masri, Maysoun Dimachkie; Ortiz, Judith

    2013-01-01

    Organisations across the country are transforming the way they deliver care, in ways similar to the accountable care organisation (ACO) model supported by Medicare. ACOs modalities are varying in size, type, and financing structure. Little is known about how specific infrastructural mechanisms influence hospital managers’ pro-ACO orientation. Using an electronic-survey of hospital managers, this study explores how pro-ACO orientation, as a latent construct, is captured from the perceptions of hospital managers; and identify infrastructural mechanisms leading to the formation of pro-ACO orientation. Of the total hospital respondents, 58% are moving toward the establishment of ACOs; 56% are planning to join in the next two years; 48% are considering joining ACOs; while 25% had already participated in ACOs during 2012. Urban hospitals are more likely than rural hospitals to be engaged in ACO development. The health provider network size is one of the strongest indicators in predicting pro-ACO orientation. PMID:25374609

  20. Combined audit of hospital antibiotic use and a prevalence survey of healthcare-associated infection.

    LENUS (Irish Health Repository)

    O'Neill, E

    2010-05-01

    Appropriate antibiotic use improves patient outcome and prevents the emergence of antibiotic resistance. A point-prevalence audit of antibiotic use at Beaumont Hospital, Dublin was carried out during the collection of data for the 2006 Hospital Infection Society (HIS) Prevalence Survey of Healthcare-Associated Infection. All inpatients who met the HIS survey entry criteria were included in the HIS survey, and all inpatients who were receiving antibiotics at the time of the survey were included in the point-prevalence audit of antibiotic use. Among these, 7.18% and 36.8% of patients had a healthcare-associated infection (HCAI) and were on antibiotics, respectively. Unnecessary collection of duplicate data was avoided by conducting an audit of antibiotic use and a national survey of HCAI simultaneously.

  1. Occupational burnout and work factors in community and hospital midwives: a survey analysis.

    Science.gov (United States)

    Yoshida, Yukiko; Sandall, Jane

    2013-08-01

    community-based midwifery practice has been promoted in the UK maternity policy over the last decade as a means of increasing continuity of care. However, there have been growing concerns to suggest that the community-based continuity model may not be sustainable due to the high levels of occupational burnout in midwives resulted by increased on-call work. this paper attempted to identify work factors associated with the levels of burnout in community midwives as compared to hospital midwives, aiming at contributing to the debate of organising sustainable midwifery care. a statistical analysis was conducted drawing on data from a survey of all midwives working at one Hospital Trust in England (n=238). Occupational burnout was measured using the Maslach Burnout Inventory (MBI). the sample midwives (n=128, 54%) had significantly higher levels of burnout compared to the reference groups. Multiple regression analysis identified as follows: (1) high levels of occupational autonomy were a key protective factor of burnout, and more prevalent in the community, (2) working hours were positively associated with burnout, and community midwives were more likely to have higher levels of stress recognition, and (3) support for work-life-balance from the Trust had a significant protective effect on the levels of burnout. the results should be taken into account in the maternity policy in order to incorporate continuity of care and sustainable organisation of midwifery care. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. CNMI Shore-based Creel Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Commonwealth of the Northern Mariana Islands (CNMI), Division of Fish and Wildlife (DFW) staff conducted shore-based creel surveys which have 2 major...

  3. Guam Boat-based Creel Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Similar to other boat-based survey in basic design, this system is run by the Div. of Aquatic and Wildlife Resources (DAWR) and has been in operation since about...

  4. Building Assessment Survey and Evaluation Data (BASE)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Building Assessment Survey and Evaluation (BASE) study was a five year study to characterize determinants of indoor air quality and occupant perceptions in...

  5. Encuesta sobre bioética en un historial de pediatría: Bases para futuras estrategias Survey on bioethics in a pediatric hospital: Basis for new strategies

    Directory of Open Access Journals (Sweden)

    Dolores Lynch Pueyrredon

    2004-02-01

    Full Text Available La ética médica (EM forma parte de la medicina desde sus comienzos pero recién en las últimas décadas se la reconoce como disciplina independiente. Se realizó un estudio observacional y descriptivo a médicos del Hospital de Niños Ricardo Gutiérrez para determinar: a el conocimiento de conceptos básicos de EM entre sus miembros, b la inserción y función del comité de bioética (CB en dicha institución. Se repartieron 150 encuestas, se recuperaron 90 (60%. Los conceptos teóricos de EM (definiciones de bioética, paciente terminal, autonomía, justicia, beneficencia, y consentimiento informado fueron respondidos correctamente por el 75.2%. Conocía la existencia del CB el 97.8%. Lo había consultado alguna vez el 61.1%. De aquellos que consultaron, la recomendación sugerida por el CB para resolver el dilema ético presentado fue: totalmente útil, para el 23.6%, parcialmente útil para el 45.5%, y no útil para el 27.3%. Nunca había consultado al CB el 37.8%, del cual el 64.7% refería no haber tenido dilema, el 11.7% consideraba no útil"a priori" la posible respuesta del CB, el 11.7% no justificó la causa, el 2.9% no distinguió los dilemas y a otro 2.9% no se le ocurrió consultar. La mayoría de los que respondieron tenía información adecuada sobre conceptos básicos de EM. Tanto el índice de consultas al CB como la valoración de sus dictámenes como total o parcialmente útiles (69.1% avalan la acción del mismo. Es llamativo que el principal argumento por el cual no se consultó al CB fue el no tener dilemas éticos. Tanto el CB en el HNRG como las universidades deberían intensificar la docencia en EM, fundamentalmente en los aspectos prácticos, que facilitaría a los integrantes del equipo de salud detectar dilemas éticos.Although medical ethics is part of medicine since its beginning, it is only in the last decades that it is recognized as a necessary discipline. A survey of pediatricians of Hospital de Ni

  6. Screening and contact precautions – A survey on infection control measures for multidrug-resistant bacteria in German university hospitals

    Directory of Open Access Journals (Sweden)

    Lena M. Biehl

    2017-04-01

    Full Text Available Abstract To assess the scope of infection control measures for multidrug-resistant bacteria in high-risk settings, a survey among university hospitals was conducted. Fourteen professionals from 8 sites participated. Reported policies varied largely with respect to the types of wards conducting screening, sample types used for screening and implementation of contact precautions. This variability among sites highlights the need for an evidence-based consensus of current infection control policies.

  7. Survey on medical information education for radiologic technologists working at hospitals

    International Nuclear Information System (INIS)

    Ikeda, Ryuji; Ogasawara, Katsuhiko; Okuda, Yasuo; Konishi, Yasuhiko; Ohoba, Hisateru; Hoshino, Shuhei; Hosoba, Minoru

    2011-01-01

    Recently, the importance of medical information for radiologic technologists has increased. The purpose of this questionnaire survey was to clarify the method of acquiring skill in medical information for radiologic technologists from the point of view of the managers of radiology departments. The questionnaire was sent to 260 hospitals that had introduced picture archiving and communication systems (PACSs) for the person responsible for medical information in the radiology department. The response rate was 35.4% (92 hospitals). The results of this survey clarified that few hospital have staff for medical information in the radiology department. Nevertheless, the excellent staff who have the skills to troubleshoot and develop systems are earnestly needed in radiology departments. To solve this problem, many technologists should understand the content, work load, and necessity of medical information. In addition, cooperation between radiologic technologist schools and hospitals is important in the field of medical information education. (author)

  8. Survey of pharmacy involvement in hospital medication reconciliation programs across the United States

    Directory of Open Access Journals (Sweden)

    Gregory R Stein

    2015-11-01

    Full Text Available Objective: The objective of this study is to conduct a review of pertinent literature, assess pharmacy involvement in medication reconciliation, and offer insight into best practices for hospitals to implement and enhance their medication reconciliation programs. Method: Pharmacists in hospitals nationwide were asked to complete an anonymous survey via the American College of Clinical Pharmacy online database. The multiple choice survey analyzed the roles that healthcare professionals play in medication reconciliation programs at hospitals. Results: Of the survey responses received, 32/91 (35% came from pharmacists at hospitals with a pharmacy-led medication reconciliation program. Of these pharmacy-led programs, 17/32 (53% have a dedicated pharmacist or pharmacy staff to perform medication reconciliation. Conclusion: A comprehensive review of literature suggests that pharmacy involvement has the potential to reduce medication reconciliation errors and may improve patient satisfaction. Focused, full-time medication reconciliation pharmacists can help hospitals save time and money, improve outcomes, and meet higher standards issued by the Joint Commission. Data obtained in this study show the extent to which pharmacists contribute to achieving these goals in healthcare systems nationwide. This baseline study provides a strong case for hospitals to implement a pharmacy-led medication reconciliation program.

  9. Survey of advanced radiation technologies used at designated cancer care hospitals in Japan

    International Nuclear Information System (INIS)

    Shikama, Naoto; Tsujino, Kayoko; Nakamura, Katsumasa; Ishikura, Satoshi

    2014-01-01

    Our survey assessed the use of advanced radiotherapy technologies at the designated cancer care hospitals in Japan, and we identified several issues to be addressed. We collected the data of 397 designated cancer care hospitals, including information on staffing in the department of radiation oncology (e.g. radiation oncologists, medical physicists and radiation therapists), the number of linear accelerators and the implementation of advanced radiotherapy technologies from the Center for Cancer Control and Information Services of the National Cancer Center, Japan. Only 53% prefectural designated cancer care hospitals and 16% regional designated cancer care hospitals have implemented intensity-modulated radiotherapy for head and neck cancers, and 62% prefectural designated cancer care hospitals and 23% regional designated cancer care hospitals use intensity-modulated radiotherapy for prostate cancer. Seventy-four percent prefectural designated cancer care hospitals and 40% regional designated cancer care hospitals employ stereotactic body radiotherapy for lung cancer. Our multivariate analysis of prefectural designated cancer care hospitals which satisfy the institute's qualifications for advanced technologies revealed the number of radiation oncologists (P=0.01) and that of radiation therapists (P=0.003) were significantly correlated with the implementation of intensity-modulated radiotherapy for prostate cancer, and the number of radiation oncologists (P=0.02) was correlated with the implementation of stereotactic body radiotherapy. There was a trend to correlate the number of medical physicists with the implementation of stereotactic body radiotherapy (P=0.07). Only 175 (51%) regional designated cancer care hospitals satisfy the institute's qualification of stereotactic body radiotherapy and 76 (22%) satisfy that of intensity-modulated radiotherapy. Seventeen percent prefectural designated cancer care hospitals and 13% regional designated cancer care hospitals

  10. Results of a Nationwide Capacity Survey of Hospitals Providing Trauma Care in War-Affected Syria.

    Science.gov (United States)

    Mowafi, Hani; Hariri, Mahmoud; Alnahhas, Houssam; Ludwig, Elizabeth; Allodami, Tammam; Mahameed, Bahaa; Koly, Jamal Kaby; Aldbis, Ahmed; Saqqur, Maher; Zhang, Baobao; Al-Kassem, Anas

    2016-09-01

    The Syrian civil war has resulted in large-scale devastation of Syria's health infrastructure along with widespread injuries and death from trauma. The capacity of Syrian trauma hospitals is not well characterized. Data are needed to allocate resources for trauma care to the population remaining in Syria. To identify the number of trauma hospitals operating in Syria and to delineate their capacities. From February 1 to March 31, 2015, a nationwide survey of 94 trauma hospitals was conducted inside Syria, representing a coverage rate of 69% to 93% of reported hospitals in nongovernment controlled areas. Identification and geocoding of trauma and essential surgical services in Syria. Although 86 hospitals (91%) reported capacity to perform emergency surgery, 1 in 6 hospitals (16%) reported having no inpatient ward for patients after surgery. Sixty-three hospitals (70%) could transfuse whole blood but only 7 (7.4%) could separate and bank blood products. Seventy-one hospitals (76%) had any pharmacy services. Only 10 (11%) could provide renal replacement therapy, and only 18 (20%) provided any form of rehabilitative services. Syrian hospitals are isolated, with 24 (26%) relying on smuggling routes to refer patients to other hospitals and 47 hospitals (50%) reporting domestic supply lines that were never open or open less than daily. There were 538 surgeons, 378 physicians, and 1444 nurses identified in this survey, yielding a nurse to physician ratio of 1.8:1. Only 74 hospitals (79%) reported any salary support for staff, and 84 (89%) reported material support. There is an unmet need for biomedical engineering support in Syrian trauma hospitals, with 12 fixed x-ray machines (23%), 11 portable x-ray machines (13%), 13 computed tomographic scanners (22%), 21 adult (21%) and 5 pediatric (19%) ventilators, 14 anesthesia machines (10%), and 116 oxygen cylinders (15%) not functional. No functioning computed tomographic scanners remain in Aleppo, and 95 oxygen cylinders (42

  11. ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration--2014.

    Science.gov (United States)

    Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

    2015-07-01

    The results of the 2014 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are described. A stratified random sample of pharmacy directors at 1435 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 29.7%. Ninety-seven percent of hospitals used automated dispensing cabinets in their medication distribution systems, 65.7% of which used individually secured lidded pockets as the predominant configuration. Overall, 44.8% of hospitals used some form of machine-readable coding to verify doses before dispensing in the pharmacy. Overall, 65% of hospital pharmacy departments reported having a cleanroom compliant with United States Pharmacopeia chapter 797. Pharmacists reviewed and approved all medication orders before the first dose was administered, either onsite or by remote order view, except in procedure areas and emergency situations, in 81.2% of hospitals. Adoption rates of electronic health information have rapidly increased, with the widespread use of electronic health records, computer prescriber order entry, barcodes, and smart pumps. Overall, 31.4% of hospitals had pharmacists practicing in ambulatory or primary care clinics. Transitions-of-care services offered by the pharmacy department have generally increased since 2012. Discharge prescription services increased from 11.8% of hospitals in 2012 to 21.5% in 2014. Approximately 15% of hospitals outsourced pharmacy management operations to a contract pharmacy services provider, an increase from 8% in 2011. Health-system pharmacists continue to have a positive impact on improving healthcare through programs that improve the efficiency, safety, and clinical outcomes of medication use in health systems. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  12. Competency Based Hospital Radiopharmacy Training. Additional Information

    International Nuclear Information System (INIS)

    2010-01-01

    Quality management systems in nuclear medicine are vital to a high level of nuclear medicine (NM) practice. Trained and competent staffs are essential for achieving high standards and growth in NM. One of the key bottlenecks for NM is the shortfall in human resources, especially of radiopharmacists. There is an acute shortage in most Member States and in some countries an absence of nationally registered pharmacists with radiopharmacy experience. Most nuclear medicine facilities operate their radiopharmacies (commonly referred to as the hot laboratories) with the support of technologists and radiographers. Recent surveys have found the level of training amongst technologists to be extremely variable. Most had little or no training in hot laboratory practices. The survey also indicated the poor state of hot laboratories in many countries. Basic quality systems in the hot laboratory could be improved significantly with better training. This competency-based education manual is designed with those radiopharmacy practitioners in mind. This competency-based trainer's manual provides trainers in each of the IAEA regions with the essentials of a training programme for all radiopharmacy practitioners. The competency-based training is a two week programme followed up with three months of practice achievements. The syllabus provides a standardized approach to lectures, practical sessions, and interactive workshops focusing on critical aspects of hot laboratory practices. The trainers, with the assistance of this manual, can deliver essential skills, competencies, and underpinning knowledge to operate safely and effectively in their hot laboratory. The course focuses on simple but practical steps that could be undertaken to improve staff performance. In addition, a basic framework of quality management principles related to radiopharmacy practices is also covered. Further, the syllabus can be adapted to the particular needs and characteristics of any training centre, country

  13. Responding to Emotional Stress in Pediatric Hospitals: Results From a National Survey of Chief Nursing Officers.

    Science.gov (United States)

    Huetsch, Michael; Green, Jeremy

    2016-01-01

    The aim of this study was to identify leadership awareness of emotional stress and employee support efforts in pediatric hospitals. The current pediatric environment has seen increases in treatment intensity, care duration, and acuity of patients resulting in increased likelihood of being exposed to emotional events. Mail survey was sent to chief nursing officers at 87 pediatric hospitals. A total of 49 responses (56%) were received. Hospitals with less than 250 beds were significantly more likely to rate emotional stress as a large to very large problem, whereas ANCC Magnet® hospitals felt better about support efforts after patient deaths. Most commonly used support offerings focused on staff recovery after a traumatic event as opposed to training for prevention of emotional stress. Emotional stress is a well-recognized issue in pediatric hospitals with comparatively large resource commitment. Further focus on caregiver prevention training and unit leadership recognition of stress may be needed.

  14. A survey of workplace violence against physicians in the hospitals, Myanmar.

    Science.gov (United States)

    Kasai, Yuichi; Mizuno, Tetsutaro; Sakakibara, Toshihiko; Thu, Si; Kyaw, Thein Aung; Htun, Kyaw Aung

    2018-02-15

    Workplace violence in hospitals is recently becoming a major global concern in many countries. However, in Myanmar, we have felt that patients and their families have rarely made unreasonable complaints in hospitals, and then, the purpose of this study is to report the current state of workplace violence in hospitals in Myanmar. Participants are 196 physicians (108 males and 88 females) in hospitals in Myanmar. A descriptive survey was conducted in regard to verbal abuse and physical violence from patients or the people concerned. At the results of this study, the percentages of physicians who have encountered verbal abuse and those who have encountered physical violence are markedly low (8.7 and 1.0%, respectively). The present study is the first to report the frequencies of verbal abuse and physical violence against physicians in a least developed country, and the results of the present study are important in terms of discussing workplace violence in hospitals.

  15. A survey of inpatient practitioner knowledge of penicillin allergy at 2 community teaching hospitals.

    Science.gov (United States)

    Staicu, Mary L; Soni, Dipekka; Conn, Kelly M; Ramsey, Allison

    2017-07-01

    The negative effect of the penicillin allergy label on antibiotic use and patient outcomes has brought to light the need for thorough penicillin allergy assessments and heightened practitioner education. To evaluate practitioner knowledge of penicillin allergy and the clinical approach to the patients with penicillin allergy. An electronic survey was distributed to attending physicians, residents, pharmacists, nurse practitioners, and physician assistants practicing adult inpatient medicine at 2 community-based teaching hospitals from February to April 2016. A total of 276 (39%) of 716 practitioners completed surveys were analyzed. Most respondents were attending physicians (45%) with more than 10 years of experience (53%). Approximately half of the respondents indicated that they were unfamiliar with the rate of cross-reactivity between penicillin and cephalosporin (46%), carbapenem (42%), and monobactam (48%) antibiotics. When evaluating the role of penicillin skin testing and temporary induction of drug tolerance in the case vignettes, only 41% and 19% of respondents appropriately considered these options as the leading antibiotic management plan, respectively. Despite acknowledging the need for allergy/immunology consultation in clinical scenarios, 86% of respondents indicated that they never consult an allergist or immunologist or do so only once per year. Overall, pharmacists had a better understanding of the natural history of penicillin allergy and antibiotic cross-reactivity (P penicillin allergy in the hospital setting, where collaborative efforts between allergy and nonallergy health care practitioners are sparse. The expansion of a multidisciplinary approach may optimize antimicrobial prescribing in this subset of patients. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Point prevalence survey of antimicrobial use in Chinese hospitals in 2012.

    Science.gov (United States)

    Ren, Nan; Zhou, Pengcheng; Wen, Ximao; Li, Chunhui; Huang, Xun; Guo, Yanhong; Meng, Li; Gong, Ruie; Feng, Li; Fu, Chenchao; Wu, Anhua

    2016-03-01

    In China, several measures have been adopted to decrease unnecessary antimicrobial overuse since 2010. This study aimed to identify characteristics of antimicrobial use in Chinese hospitals after implementing these measures and to explore additional targets for future antimicrobial stewardship. In 2012, point prevalence surveys conducted in Chinese hospitals included inpatients who were admitted for at least 24 hours. Details regarding infection, antimicrobial use, and bacterial cultures were recorded. A survey of 786,028 inpatients in 1,313 hospitals included prevalence of health care-associated (3.22%) and community-acquired infections (22.52%); antimicrobial use prevalence (AUP, 38.39%); bacterial culture rate (BCR, 40.16%); and proportions of administration of a single antimicrobial (75.33%), therapeutic (23.16%), prophylactic (11.99%), and therapeutic plus prophylactic (3.24%) AUP rates. Prophylactic AUP rates of hospitals with AUP rates for surgical patients with classes I, II, and III wounds were 45.19%, 68.18%, and 68.47%, respectively. Prophylactic AUP rates for surgical patients decreased with increasing hospital bed numbers. These indices varied among different hospital departments. More efforts are needed toward small hospitals, prophylactic antimicrobial use for surgical patients, and departments with low BCRs to optimize the clinical antimicrobial use. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Nurse perceptions of safety climate in Australian acute hospitals: a cross-sectional survey.

    Science.gov (United States)

    Soh, Sze-Ee; Morello, Renata; Rifat, Sheral; Brand, Caroline; Barker, Anna

    2017-03-16

    Objectives The aim of the present study was to explore nurse perceptions of safety climate in acute Australian hospitals. Methods Participants included 420 nurses who have worked on 24 acute wards from six Australian hospitals. The Safety Attitudes Questionnaire (SAQ) Short Form was used to quantify nurse perceptions of safety climate and benchmarked against international data. Generalised linear mixed models were used to explore factors that may influence safety climate. Results On average, 53.5% of nurses held positive attitudes towards job satisfaction followed by teamwork climate (50.5%). There was variability in SAQ domain scores across hospitals. The safety climate and perceptions of hospital management domains also varied across wards within a hospital. Nurses who had worked longer at a hospital were more likely to have poorer perceptions of hospital management (β=-5.2; P=0.014). Overall, nurse perceptions of safety climate appeared higher than international data. Conclusions The perceptions of nurses working in acute Victorian and New South Wales hospitals varied between hospitals as well as across wards within each hospital. This highlights the importance of surveying all hospital wards and examining the results at the ward level when implementing strategies to improve patient safety and the culture of safety in organisations. What is known about the topic? Prior studies in American nursing samples have shown that hospitals with higher levels of safety climate have a lower relative incidence of preventable patient complications and adverse events. Developing a culture of safety in hospitals may be useful in targeting efforts to improve patient safety. What does this paper add? This paper has shown that the perceptions of safety climate among nurses working in acute Australian hospitals varied between hospitals and across wards within a hospital. Only half the nurses also reported positive attitudes towards job satisfaction and teamwork climate. What are

  18. A survey of digital radiography practice in four South African teaching hospitals: an illuminative study.

    Science.gov (United States)

    Nyathi, T; Chirwa, Tf; van der Merwe, Dg

    2010-01-01

    The purpose of this study was to assess radiographer familiarity and preferences with digital radiography in four teaching hospitals and thereafter make recommendations in line with the migration from screen film to digital radiography. A questionnaire was designed to collect data from either qualified or student radiographers from four teaching hospitals. From the four teaching hospitals, there were a total of 205 potential respondents. Among other things, responses regarding experiences and preferences with digital radiography, quality control procedures, patient dose, advantages and disadvantages of digital radiography were sought. The information collected was based on self-reporting by the participants. The study is exploratory in nature and descriptive statistics were generated from the collected data using Microsoft Excel 2007 and StatsDirect software. Sixty-three out of 205 (31%) radiographers from all the four radiology centers responded to the circulated questionnaire. Only 15% (8) of the qualified radiographers had 4 or more years of experience with digital radiography compared to 68% (36) for the same amount of experience with screen-film radiography. Sixty-one percent (38) of the participants had been exposed to digital radiography during their lectures while at university. A small proportion, 16% (10) of the respondents underwent formal training in quality control procedures on the digital X-ray units they were using. Slightly more than half (55%) of the participants felt it was easier for them to retake an image in digital radiography than in screen film radiography. The results of this survey showed that the participants are familiar with digital radiography and have embraced this relatively new technology as shown by the fact that they can identify both its advantages and disadvantages as applied to clinical practice. However, there are minimal quality control procedures specific to digital radiography being undertaken as such there is need for

  19. Multi-state survey of healthcare-associated infections in acute care hospitals in Brazil.

    Science.gov (United States)

    Fortaleza, C Magno Castelo Branco; Padoveze, M C; Kiffer, C R Veiga; Barth, A L; Carneiro, Irna C do Rosário Souza; Giamberardino, H I Garcia; Rodrigues, J L Nobre; Santos Filho, L; de Mello, M J Gonçalves; Pereira, M Severino; Gontijo Filho, P Pinto; Rocha, M; Servolo de Medeiros, E A; Pignatari, A C Campos

    2017-06-01

    Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (48 h of admission to the study hospitals at the time of the survey were included. Trained epidemiologist nurses visited each hospital and collected data on HCAIs, subjects' demographics, and invasive procedures. Univariate and multivariate techniques were used for data analysis. The overall HCAI prevalence was 10.8%. Most frequent infection sites were pneumonia (3.6%) and bloodstream infections (2.8%). Surgical site infections were found in 1.5% of the whole sample, but in 9.8% of subjects who underwent surgical procedures. The overall prevalence was greater for reference (12.6%) and large hospitals (13.5%), whereas medium- and small-sized hospitals presented rates of 7.7% and 5.5%, respectively. Only minor differences were noticed among hospitals from different macro-regions. Patients in intensive care units, using invasive devices or at extremes of age were at greater risk for HCAIs. Prevalence rates were high in all geographic regions and hospital sizes. HCAIs must be a priority in the public health agenda of developing countries. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  20. Exploring improvements in patient logistics in Dutch hospitals with a survey

    Directory of Open Access Journals (Sweden)

    van Lent Wineke AM

    2012-08-01

    Full Text Available Abstract Background Research showed that promising approaches such as benchmarking, operations research, lean management and six sigma, could be adopted to improve patient logistics in healthcare. To our knowledge, little research has been conducted to obtain an overview on the use, combination and effects of approaches to improve patient logistics in hospitals. We therefore examined the approaches and tools used to improve patient logistics in Dutch hospitals, the reported effects of these approaches on performance, the applied support structure and the methods used to evaluate the effects. Methods A survey among experts on patient logistics in 94 Dutch hospitals. The survey data were analysed using cross tables. Results Forty-eight percent of all hospitals participated. Ninety-eight percent reported to have used multiple approaches, 39% of them used five or more approaches. Care pathways were the preferred approach by 43% of the hospitals, followed by business process re-engineering and lean six sigma (both 13%. Flowcharts were the most commonly used tool, they were used on a regular basis by 94% of the hospitals. Less than 10% of the hospitals used data envelopment analysis and critical path analysis on a regular basis. Most hospitals (68% relied on external support for process analyses and education on patient logistics, only 24% had permanent internal training programs on patient logistics. Approximately 50% of the hospitals that evaluated the effects of approaches on efficiency, throughput times and financial results, reported that they had accomplished their goals. Goal accomplishment in general hospitals ranged from 63% to 67%, in academic teaching hospitals from 0% to 50%, and in teaching hospitals from 25% to 44%. More than 86% performed an evaluation, 53% performed a post-intervention measurement. Conclusions Patient logistics appeared to be a rather new subject as most hospitals had not selected a single approach, they relied on

  1. Exploring improvements in patient logistics in Dutch hospitals with a survey

    Science.gov (United States)

    2012-01-01

    Background Research showed that promising approaches such as benchmarking, operations research, lean management and six sigma, could be adopted to improve patient logistics in healthcare. To our knowledge, little research has been conducted to obtain an overview on the use, combination and effects of approaches to improve patient logistics in hospitals. We therefore examined the approaches and tools used to improve patient logistics in Dutch hospitals, the reported effects of these approaches on performance, the applied support structure and the methods used to evaluate the effects. Methods A survey among experts on patient logistics in 94 Dutch hospitals. The survey data were analysed using cross tables. Results Forty-eight percent of all hospitals participated. Ninety-eight percent reported to have used multiple approaches, 39% of them used five or more approaches. Care pathways were the preferred approach by 43% of the hospitals, followed by business process re-engineering and lean six sigma (both 13%). Flowcharts were the most commonly used tool, they were used on a regular basis by 94% of the hospitals. Less than 10% of the hospitals used data envelopment analysis and critical path analysis on a regular basis. Most hospitals (68%) relied on external support for process analyses and education on patient logistics, only 24% had permanent internal training programs on patient logistics. Approximately 50% of the hospitals that evaluated the effects of approaches on efficiency, throughput times and financial results, reported that they had accomplished their goals. Goal accomplishment in general hospitals ranged from 63% to 67%, in academic teaching hospitals from 0% to 50%, and in teaching hospitals from 25% to 44%. More than 86% performed an evaluation, 53% performed a post-intervention measurement. Conclusions Patient logistics appeared to be a rather new subject as most hospitals had not selected a single approach, they relied on external support and they did

  2. Exploring improvements in patient logistics in Dutch hospitals with a survey.

    Science.gov (United States)

    van Lent, Wineke A M; Sanders, E Marloes; van Harten, Wim H

    2012-08-01

    Research showed that promising approaches such as benchmarking, operations research, lean management and six sigma, could be adopted to improve patient logistics in healthcare. To our knowledge, little research has been conducted to obtain an overview on the use, combination and effects of approaches to improve patient logistics in hospitals. We therefore examined the approaches and tools used to improve patient logistics in Dutch hospitals, the reported effects of these approaches on performance, the applied support structure and the methods used to evaluate the effects. A survey among experts on patient logistics in 94 Dutch hospitals. The survey data were analysed using cross tables. Forty-eight percent of all hospitals participated. Ninety-eight percent reported to have used multiple approaches, 39% of them used five or more approaches. Care pathways were the preferred approach by 43% of the hospitals, followed by business process re-engineering and lean six sigma (both 13%). Flowcharts were the most commonly used tool, they were used on a regular basis by 94% of the hospitals. Less than 10% of the hospitals used data envelopment analysis and critical path analysis on a regular basis. Most hospitals (68%) relied on external support for process analyses and education on patient logistics, only 24% had permanent internal training programs on patient logistics. Approximately 50% of the hospitals that evaluated the effects of approaches on efficiency, throughput times and financial results, reported that they had accomplished their goals. Goal accomplishment in general hospitals ranged from 63% to 67%, in academic teaching hospitals from 0% to 50%, and in teaching hospitals from 25% to 44%. More than 86% performed an evaluation, 53% performed a post-intervention measurement. Patient logistics appeared to be a rather new subject as most hospitals had not selected a single approach, they relied on external support and they did not have permanent training programs

  3. Surveying the hidden attitudes of hospital nurses' towards poverty.

    Science.gov (United States)

    Wittenauer, James; Ludwick, Ruth; Baughman, Kristin; Fishbein, Rebecca

    2015-08-01

    To explore the attitudes held by registered nurses about persons living in poverty. As a profession, nursing has strong commitment to advocating for the socioeconomically disadvantaged. The links among poverty and health disparities are well established and research demonstrates that attitudes of providers can influence how those in poverty use health services. Although nurses are the largest sector of healthcare providers globally, little research has been published on their attitudes towards patients they care for who live in poverty. Cross-sectional survey. Used a convenience sample of 117 registered nurses who completed the Attitudes Towards Poverty Short Form that contained three subscales. Regression analysis was used to examine the associations between the nurses' age, education, and years of experience, political views and financial security with their total score and subscale scores. Nurses were more likely to agree with stigmatising statements than statements that attributed poverty to personal deficiency or structural factors. In the multivariate analysis, years of experience were associated with more positive attitudes towards those living in poverty. Nurses with the most experience had less stigmatising beliefs about poverty and were more likely to endorse structural explanations. Those with a baccalaureate education were also more likely to endorse structural explanations for poverty. Gaining knowledge about attitudes towards and the factors influencing those attitudes, for example, education, are important in helping combat the disparities associated with poverty. Nurses have a duty to evaluate their individual attitudes and biases towards those living in poverty and how those attitudes and biases may influence daily practice. Assessing nurses' attitudes towards poverty may aid in better means of empowering nurses to seek solutions that will improve health conditions for those living in poverty. © 2015 John Wiley & Sons Ltd.

  4. Patient flow based allocation of hospital resources.

    Science.gov (United States)

    Vissers, J M

    1995-01-01

    The current practice of allocating resources within a hospital introduces peaks and troughs in the workloads of departments and leads therefore to loss of capacity. This happens when requirements for capacity coordination are not adequately taken into account in the decision making process of allocating resources to specialties. The first part of this research involved an analysis of the hospital's production system on dependencies between resources, resulting in a number of capacity coordination requirements that need to be fulfilled for optimized resource utilization. The second, modelling, part of the study involved the development of a framework for resource management decision making, of a set of computer models to support hospital managerial decision making on resource allocation issues in various parts of the hospital, and of an implementation strategy for the application of the models to concrete hospital settings. The third part of the study was devoted to a number of case-studies, illustrating the use of the models when applied in various resource management projects, such as a reorganization of an operating theatre timetable, or the development of a master plan for activities of a group of general surgeons serving two locations of a merged hospital system. The paper summarizes the main findings of the study and concludes with a discussion of results obtained with the new allocation procedure and with recommendations for future research.

  5. Hospital Value-Based Purchasing Performance: Do Organizational and Market Characteristics Matter?

    Science.gov (United States)

    Spaulding, Aaron; Edwardson, Nick; Zhao, Mei

    The hospital value-based purchasing (HVBP) program of the Centers for Medicare & Medicaid Services challenges hospitals to deliver high-quality care or face a reduction in Medicare payments. How do different organizational structures and market characteristics enable or inhibit successful transition to this new model of value-based care? To address that question, this study employs an institutional theory lens to test whether certain organizational structures and market characteristics mediate hospitals' ability to perform across HVBP domains.Data from the 2014 American Hospital Association Annual Survey Database, Area Health Resource File, the Medicare Hospital Compare Database, and the association between external environment and hospital performance are assessed through multiple regression analysis. Results indicate that hospitals that belong to a system are more likely than independent hospitals to score highly on the domains associated with the HVBP incentive arrangement. However, varying and sometimes counterintuitive market influences bring different dimensions to the HVBP program. A hospital's ability to score well in this new value arrangement may be heavily based on the organization's ability to learn from others, implement change, and apply the appropriate amount of control in various markets.

  6. Target marketing for the hospital-based wellness center.

    Science.gov (United States)

    Cangelosi, J D

    1997-01-01

    The American population is aging, medical technology is advancing, and life expectancies are on the rise. At the same time hospitals are looking for additional sources of income due to the pressures of government regulations and managed care. One of the options for hospitals looking for additional sources of income is the hospital-based but free-standing comprehensive wellness and fitness center. Such centers go beyond the facilities, programs and services offered by traditional health and fitness centers. In addition to physical fitness programs, hospital-based wellness centers offer programs in CPR, nutrition, weight control and many other programs of interest to an aging but active American populace. This research documents the hospital industry, wellness industry and the prospects of success or failure for he hospital attempting such a venture. The focus of the research is the experience of a particular hospital with regard to the programs, facilities and services deemed most important by its target market.

  7. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The national average for the OAS CAHPS Survey categories. The OAS CAHPS survey collects information about patients’ experiences of care in hospital outpatient...

  8. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of the state averages for the OAS CAHPS Survey responses. The OAS CAHPS survey collects information about patients’ experiences of care in hospital outpatient...

  9. [Nationwide Survey on Informed Consent and Ethical Review at Hospitals Conducting Post-marketing Studies Sponsored by Pharmaceutical Companies].

    Science.gov (United States)

    Urushihara, Hisashi; Murakami, Yuka; Matsui, Kenji; Tashiro, Shimon

    2018-01-01

     Under the Japanese drug regulatory system, post-marketing studies (PMS) must be in compliance with Good Post-marketing Study Practice (GPSP). The GPSP Ordinance lacks standards for the ethical conduct of PMSs; although only post-marketing clinical trials are subject to Good Clinical Practice. We conducted a web-based questionnaire survey on the ethical conduct of PMSs in collaboration with the Japanese Society of Hospital Pharmacists and pharmacists belonging to the Society. 1819 hospitals around Japan answered the questionnaire, of which 503 hospitals had conducted company-sponsored PMSs in 2015. 40.2% of the hospitals had obtained informed consent from participating patients in at least one PMS conducted in 2015, the majority of which was in written form. The first and second most frequent reasons for seeking informed consent in PMSs were to meet protocol requirements, followed by the requirement to meet institutional standard operational procedures and the request of the ethical review board of the hospital. Ethical review of PMSs was conducted in 251 hospitals. Despite a lack of standards for informed consent and ethical review in PMSs, a considerable number of study sites employed informed consent and ethical review for PMSs. While company policies and protocols are likely to be major determinants of the ethical conduct of PMSs, the governmental regulatory agency should also play a significant role in implementing a standardized ethical code for the conduct of PMSs.

  10. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals

    Science.gov (United States)

    Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-01-01

    Abstract Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1–5 years and served 90–100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40–45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals

  11. Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey.

    Science.gov (United States)

    Keyvanara, Mahmoud; Sajadi, Haniye Sadat

    2015-02-12

    Changes in modern societies develop the perception that the external environment is essential in organization's practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. The mean score of hospitals' social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals' ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals' social responsibility level, especially through concentrating on their staff's working environment. © 2015 by Kerman University of Medical Sciences.

  12. A Survey on Clinical Research Training Status and Needs in Public Hospitals from Shenzhen

    Science.gov (United States)

    Ji, Ping; Wang, Haibo; Zhang, Chao; Liu, Min; Zhou, Liping; Xiao, Ping; Wang, Yanfang; Wu, Yangfeng

    2017-01-01

    Objective: To obtain information on the current clinical research training status and evaluate the training needs comprehensively for medical staff in hospitals. Methods: This survey was initiated and conducted by the Health and Family Planning Commission of Shenzhen in conjunction with the Peking University Clinical Research Institute (Shenzhen)…

  13. Information Needs and Seeking Behaviours of Nurses: A Survey of Two Hospitals in Bayelsa State, Nigeria

    Science.gov (United States)

    Baro, Emmanuel E.; Ebhomeya, Loveth

    2013-01-01

    Purpose: The purpose of this paper is to identify the information needs of nurses in two hospitals in Nigeria and the ways in which they went about attempting to meet those needs. Design/methodology/approach: The study is a descriptive survey of nurses at the Federal Medical Center (FMC), Yenagoa, and Niger Delta University Teaching Hospital…

  14. Quality Assurance Practices in Obstetric Care: A Survey of Hospitals in California.

    Science.gov (United States)

    Lundsberg, Lisbet S; Lee, Henry C; Dueñas, Grace Villarin; Gregory, Kimberly D; Grossetta Nardini, Holly K; Pettker, Christian M; Illuzzi, Jessica L; Xu, Xiao

    2018-02-01

    To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities. The association between institutional characteristics and adoption of evidence-supported practices (ie, those supported by prior literature or recommended by professional organizations as beneficial for improving birth outcome or patient safety) was examined using bivariate analysis and appropriate statistical tests. Most hospitals regularly audited adherence to written protocols regarding critical areas of care; however, 77.7% and 16.8% reported not having written guidelines on diagnosis of labor arrest and management of abnormal fetal heart rate, respectively. Private nonprofit hospitals were more likely to have a written protocol for management of abnormal fetal heart rate (P=.002). One in 10 hospitals (9.7%) did not regularly review cases with significant morbidity or mortality, and only 69.0% regularly tracked indications for cesarean delivery. Moreover, 26.3%, 14.3%, and 8.7% of the hospitals reported never performing interprofessional simulations for eclampsia, shoulder dystocia, or postpartum hemorrhage, respectively. Teaching status was associated with more frequent simulations in these three areas (P≤.04 for all), while larger volume was associated with more frequent simulations for eclampsia (P=.04). Hospitals in California engage in a wide range of practices to assure or improve quality of obstetric care, but substantial variation in practice exists among hospitals. There is opportunity for improvement in adoption of evidence-supported practices.

  15. Ranking hospitals for outcomes in total hip replacement - administrative data with or without additional patient surveys? - Part 1: Administrative data

    Directory of Open Access Journals (Sweden)

    Dörning, Hans

    2007-03-01

    Full Text Available Background: Many hospital rankings rely on the frequency of adverse outcomes and are based on administrative data. In the study presented here, we tried to find out, to what extent available administrative data of German Sickness Funds allow for an adequate hospital ranking and compared this with rankings based on additional information derived from a patient survey. Total hip replacement was chosen as an example procedure. In part I of the publication, we present the results of the approach based on administrative data. Methods: We used administrative data from the AOK-Lower Saxony of the years 2000, 2001 and 2002. The study population comprised all beneficiaries, who received total hip replacement in the years 2000 or 2001. Performance indicators used where “critical incident (Mortality or revision” and “number of revisions” within the first year. Hospitals were ranked if they performed at least 20 procedures on AOK-beneficiaries in each of the two years. Multivariate modelling (logistic and poisson regression was used to estimate the performance indicators by case-mix variables (age, sex, co-diagnoses and hospital characteristics (hospital size, surgical volume. The actual ranking was based on these multivariate models, excluding hospital variables and adding dummy-variables for each hospital. Hospitals were ranked by their case-mix adjusted odds ratio or SMR respectively with respect to a pre-selected reference hospital. The resulting rankings were compared with each other, with regard to temporal stability, and the impact of case-mix variables.Results: About 4500 beneficiaries received total hip replacement in each year (n2000: 4482; n2001: 4579. The ranking included 65 hospitals. Comparing the years 2000 and 2001, the temporal stability of the rankings based on a single performance indicator was low (Spearman rang correlation coefficients 0.158 and 0.191. The agreement of rankings based on different performance indicators in the

  16. Hospital safety culture in Taiwan: a nationwide survey using Chinese version Safety Attitude Questionnaire.

    Science.gov (United States)

    Lee, Wui-Chiang; Wung, Hwei-Ying; Liao, Hsun-Hsiang; Lo, Chien-Ming; Chang, Fei-Ling; Wang, Pa-Chun; Fan, Angela; Chen, Hsin-Hsin; Yang, Han-Chuan; Hou, Sheng-Mou

    2010-08-10

    Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan. The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C). Hospitals and their healthcare workers participated in the survey on a voluntary basis. The psychometric properties of the five SAQ-C dimensions were examined, including teamwork climate, safety climate, job satisfaction, perception of management, and working conditions. Additional safety measures were asked to assess healthcare workers' attitudes toward their collaboration with nurses, physicians, and pharmacists, respectively, and perceptions of hospitals' encouragement of safety reporting, safety training, and delivery delays due to communication breakdowns in clinical areas. The associations between the respondents' attitudes to each SAQ-C dimension and safety measures were analyzed by generalized estimating equations, adjusting for the clustering effects at hospital levels. A total of 45,242 valid questionnaires were returned from 200 hospitals with a mean response rate of 69.4%. The Cronbach's alpha was 0.792 for teamwork climate, 0.816 for safety climate, 0.912 for job satisfaction, 0.874 for perception of management, and 0.785 for working conditions. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct. The percentage of hospital healthcare workers holding positive attitude was 48.9% for teamwork climate, 45.2% for perception of management, 42.1% for job satisfaction, 37.2% for safety climate, and 31.8% for working conditions. There were wide variations in the range of SAQ-C scores in each dimension among hospitals. Compared to those without positive attitudes, healthcare workers with positive attitudes to each SAQ

  17. Patient satisfaction between primary care providers and hospitals: a cross-sectional survey in Jilin province, China.

    Science.gov (United States)

    Li, Jinghua; Wang, Pingping; Kong, Xuan; Liang, Hailun; Zhang, Xiumin; Shi, Leiyu

    2016-06-01

    To assess patient satisfaction with outpatient and inpatient care between primary care providers and secondary/tertiary hospitals, and to examine its association with socio-demographic characteristics and type of institution, based on self-reported survey data. Cross-sectional survey. Healthcare facilities within Jilin province, China. In total, 993 outpatients and 925 inpatients aged ≥15 years old were recruited. Patient satisfaction with the care experience. Patient satisfaction with outpatient and inpatient care was significantly associated with type of healthcare delivery setting in Jilin, China. Seeking outpatient care from community health centers (CHCs) was significantly associated with a higher ratio of patient satisfaction. Patients of county and tertiary hospitals complained about long-waiting times, bad attitudes of health workers, high expense of treatment, and their overall satisfaction towards outpatient care was lower. In the terms of inpatient care, patients were more satisfied with treatment expense in CHCs compared with county hospitals. CHCs and hospitals face different challenges regarding patient satisfaction. Further healthcare reform in China need to adopt more measures (e.g. increasing quality of primary care, setting up a referral medical system etc.) to improve patient satisfaction. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  18. [Survey of methicillin-resistant Staphylococcus aureus control measures in hospitals participating in the VINCat program].

    Science.gov (United States)

    Sopena-Galindo, Nieves; Hornero-Lopez, Anna; Freixas-Sala, Núria; Bella-Cueto, Feliu; Pérez-Jové, Josefa; Limon-Cáceres, Enric; Gudiol-Munté, Francesc

    2016-01-01

    VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  19. [Inpatient acute pain management in German hospitals: results from the national survey "Akutschmerzzensus 2012"].

    Science.gov (United States)

    Erlenwein, J; Stamer, U; Koschwitz, R; Koppert, W; Quintel, M; Meißner, W; Petzke, F

    2014-04-01

    In 2007, the German national guidelines on "Treatment of acute perioperative and post-traumatic pain" were published. The aim of this study was to describe current structure and process data for acute pain management in German hospitals and to compare how the guidelines and other initiatives such as benchmarking or certification changed the healthcare landscape in the last decade. All directors of German departments of anesthesiology according to the DGAI ("Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin", German Society for Anesthesiology and Intensive Care) were mailed a standardized questionnaire on structures and processes of acute pain management in their hospitals. A total of 403 completed questionnaires (46 %) could be evaluated. Of hospitals, 81 % had an acute pain service (ASD), whereby only 45 % met defined quality criteria. Written standards for acute pain management were available in 97 % of the hospitals on surgical wards and 51 % on nonsurgical wards. In 96 %, perioperative pain was regularly recorded (generally pain at rest and/or movement, pain-related functional impairment in 16 % only). Beside these routine measurements, only 38 % of hospitals monitored pain for effectiveness after acute medications. Often interdisciplinary working groups and/or pain managers are established for hospital-wide control. As specific therapy, the patient-controlled analgesia and epidural analgesia are largely prevalent (> 90 % of all hospitals). In the last decade, intravenous and oral opioid administration of opioids (including slow release preparations) has become established in acute pain management. The survey was representative by evaluating 20 % of all German hospitals. The organizational requirements for appropriate pain management recommended by the German guidelines for acute pain recommended have been established in the hospital sector in recent years. However, the organizational enforcement for acute pain management in

  20. The study on the outsourcing of Taiwan's hospitals: a questionnaire survey research.

    Science.gov (United States)

    Hsiao, Chih-Tung; Pai, Jar-Yuan; Chiu, Hero

    2009-05-13

    The aim of this study was to assess the outsourcing situation in Taiwanese hospitals and compares the differences in hospital ownership and in accreditation levels. This research combined two kinds of methods: a questionnaire survey and the in-depth interview to two CEOs of the sample hospitals. One hospital is not-for-profit, while the other is a public hospital and the research samples are from the hospital data from Taiwan's 2005 to 2007 Department of Health qualifying lists of hospital accreditation. The returned questionnaires were analyzed with STATISTICA 7.1 version software. The results for non-medical items showed medical waste and common trash both have the highest rate (94.6 percent) of being outsourced. The gift store (75 percent) and linen (73 percent) follow close behind, while the lowest rate of outsourcing is in utility maintenance (13.5 percent). For medical items, the highest rate of outsourcing is in the ambulance units (51.4 percent), while the hemodialysis center follows close behind with a rate of 50 percent. For departments of nutrition, pharmacy, and nursing however, the outsourcing rate is lower than 3 percent. This shows that Taiwan's hospitals are still conservative in their willingness to outsource for medical items. The results of the satisfaction paired t-test show that the non-medical items have a higher score than the medical items. The factor analysis showed the three significant factors in of non medical items' outsourcing are "performance", "finance", and "human resource". For medical items, the two factors are "operation" and satisfaction". To further exam the factor validity and reliability of the satisfaction model, a confirmative factor analysis (CFA) was conducted using structure equation modeling (SEM) method and found the model fitting well. Hospitals, especially for public hospitals, can get benefits from outsourcing to revive the full-time-equivalent and human resource limitation.

  1. The study on the outsourcing of Taiwan's hospitals: a questionnaire survey research

    Directory of Open Access Journals (Sweden)

    Pai Jar-Yuan

    2009-05-01

    Full Text Available Abstract Background The aim of this study was to assess the outsourcing situation in Taiwanese hospitals and compares the differences in hospital ownership and in accreditation levels. Methods This research combined two kinds of methods: a questionnaire survey and the in-depth interview to two CEOs of the sample hospitals. One hospital is not-for-profit, while the other is a public hospital and the research samples are from the hospital data from Taiwan's 2005 to 2007 Department of Health qualifying lists of hospital accreditation. The returned questionnaires were analyzed with STATISTICA® 7.1 version software. Results The results for non-medical items showed medical waste and common trash both have the highest rate (94.6 percent of being outsourced. The gift store (75 percent and linen (73 percent follow close behind, while the lowest rate of outsourcing is in utility maintenance (13.5 percent. For medical items, the highest rate of outsourcing is in the ambulance units (51.4 percent, while the hemodialysis center follows close behind with a rate of 50 percent. For departments of nutrition, pharmacy, and nursing however, the outsourcing rate is lower than 3 percent. This shows that Taiwan's hospitals are still conservative in their willingness to outsource for medical items. The results of the satisfaction paired t-test show that the non-medical items have a higher score than the medical items. The factor analysis showed the three significant factors in of non medical items' outsourcing are "performance", "finance", and "human resource". For medical items, the two factors are "operation" and satisfaction". To further exam the factor validity and reliability of the satisfaction model, a confirmative factor analysis (CFA was conducted using structure equation modeling (SEM method and found the model fitting well. Conclusion Hospitals, especially for public hospitals, can get benefits from outsourcing to revive the full-time-equivalent and human

  2. Value-based purchasing and hospital acquired conditions: are we seeing improvement?

    Science.gov (United States)

    Spaulding, Aaron; Zhao, Mei; Haley, D Rob

    2014-12-01

    To determine if the Value-Based Purchasing Performance Scoring system correlates with hospital acquired condition quality indicators. This study utilizes the following secondary data sources: the American Hospital Association (AHA) annual survey and the Centers for Medicare and Medicaid (CMS) Value-Based Purchasing and Hospital Acquired Conditions databases. Zero-inflated negative binomial regression was used to examine the effect of CMS total performance score on counts of hospital acquired conditions. Hospital structure variables including size, ownership, teaching status, payer mix, case mix, and location were utilized as control variables. The secondary data sources were merged into a single database using Stata 10. Total performance scores, which are used to determine if hospitals should receive incentive money, do not correlate well with quality outcome in the form of hospital acquired conditions. Value-based purchasing does not appear to correlate with improved quality and patient safety as indicated by Hospital Acquired Condition (HAC) scores. This leads us to believe that either the total performance score does not measure what it should, or the quality outcome measurements do not reflect the quality of the total performance scores measure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Admission rates in a general practitioner-based versus a hospital specialist based, hospital-at-home model

    DEFF Research Database (Denmark)

    Mogensen, Christian Backer; Ankersen, Ejnar Skytte; Lindberg, Mats J

    2018-01-01

    . CONCLUSIONS: The GP based HaH model was more effective than the hospital specialist model in avoiding hospital admissions within 7 days among elderly patients with an acute medical condition with no differences in mental or physical recovery rates or deaths between the two models. REGISTRATION: No. NCT......BACKGROUND: Hospital at home (HaH) is an alternative to acute admission for elderly patients. It is unclear if should be cared for a primarily by a hospital intern specialist or by the patient's own general practitioner (GP). The study assessed whether a GP based model was more effective than...... Denmark, including + 65 years old patients with an acute medical condition that required acute hospital in-patient care. The patients were randomly assigned to hospital specialist based model or GP model of HaH care. Five physical and cognitive performance tests were performed at inclusion and after 7...

  4. Development of a patient safety climate survey for Chinese hospitals: cross-national adaptation and psychometric evaluation.

    Science.gov (United States)

    Zhu, Junya; Li, Liping; Zhao, Hailei; Han, Guangshu; Wu, Albert W; Weingart, Saul N

    2014-10-01

    Existing patient safety climate instruments, most of which have been developed in the USA, may not accurately reflect the conditions in the healthcare systems of other countries. To develop and evaluate a patient safety climate instrument for healthcare workers in Chinese hospitals. Based on a review of existing instruments, expert panel review, focus groups and cognitive interviews, we developed items relevant to patient safety climate in Chinese hospitals. The draft instrument was distributed to 1700 hospital workers from 54 units in six hospitals in five Chinese cities between July and October 2011, and 1464 completed surveys were received. We performed exploratory and confirmatory factor analyses and estimated internal consistency reliability, within-unit agreement, between-unit variation, unit-mean reliability, correlation between multi-item composites, and association between the composites and two single items of perceived safety. The final instrument included 34 items organised into nine composites: institutional commitment to safety, unit management support for safety, organisational learning, safety system, adequacy of safety arrangements, error reporting, communication and peer support, teamwork and staffing. All composites had acceptable unit-mean reliabilities (≥0.74) and within-unit agreement (Rwg ≥0.71), and exhibited significant between-unit variation with intraclass correlation coefficients ranging from 9% to 21%. Internal consistency reliabilities ranged from 0.59 to 0.88 and were ≥0.70 for eight of the nine composites. Correlations between composites ranged from 0.27 to 0.73. All composites were positively and significantly associated with the two perceived safety items. The Chinese Hospital Survey on Patient Safety Climate demonstrates adequate dimensionality, reliability and validity. The integration of qualitative and quantitative methods is essential to produce an instrument that is culturally appropriate for Chinese hospitals

  5. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K

    2012-01-01

    , as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory......The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment...

  6. Internal Medicine Residents' Perceived Responsibility for Patients at Hospital Discharge: A National Survey.

    Science.gov (United States)

    Young, Eric; Stickrath, Chad; McNulty, Monica C; Calderon, Aaron J; Chapman, Elizabeth; Gonzalo, Jed D; Kuperman, Ethan F; Lopez, Max; Smith, Christopher J; Sweigart, Joseph R; Theobald, Cecelia N; Burke, Robert E

    2016-12-01

    Medical residents are routinely entrusted with transitions of care, yet little is known about the duration or content of their perceived responsibility for patients they discharge from the hospital. To examine the duration and content of internal medicine residents' perceived responsibility for patients they discharge from the hospital. The secondary objective was to determine whether specific individual experiences and characteristics correlate with perceived responsibility. Multi-site, cross-sectional 24-question survey delivered via email or paper-based form. Internal medicine residents (post-graduate years 1-3) at nine university and community-based internal medicine training programs in the United States. Perceived responsibility for patients after discharge as measured by a previously developed single-item tool for duration of responsibility and novel domain-specific questions assessing attitudes towards specific transition of care behaviors. Of 817 residents surveyed, 469 responded (57.4 %). One quarter of residents (26.1 %) indicated that their responsibility for patients ended at discharge, while 19.3 % reported perceived responsibility extending beyond 2 weeks. Perceived duration of responsibility did not correlate with level of training (P = 0.57), program type (P = 0.28), career path (P = 0.12), or presence of burnout (P = 0.59). The majority of residents indicated they were responsible for six of eight transitional care tasks (85.1-99.3 % strongly agree or agree). Approximately half of residents (57 %) indicated that it was their responsibility to directly contact patients' primary care providers at discharge. and 21.6 % indicated that it was their responsibility to ensure that patients attended their follow-up appointments. Internal medicine residents demonstrate variability in perceived duration of responsibility for recently discharged patients. Neither the duration nor the content of residents' perceived responsibility was

  7. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Science.gov (United States)

    Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

    2016-01-01

    Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a

  8. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Directory of Open Access Journals (Sweden)

    Jeevan Acharya

    Full Text Available Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs.A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study.The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%, clothes (9.8% and transport (7.3%. For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007, employed house head (p = 0.011, monthly family income more than 25,000 NRs (Nepalese Rupees (p = 0.014, private hospital as a place of delivery (p = 0.0001, C-section as a mode of delivery (p = 0.0001, longer duration (>5days of stay in hospital (p = 0.0001, longer distance (>15km from house to hospital (p = 0.0001 and longer travel time (>240 minutes from house to hospital (p = 0.007 showed a significant association with the higher hidden costs (>25000 NRs.Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time were associated with hidden costs. Hidden costs can be a

  9. Japanese structure survey of radiation oncology in 2007 with special reference to designated cancer care hospitals

    International Nuclear Information System (INIS)

    Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi

    2011-01-01

    Background and Purpose: The structure of radiation oncology in designated cancer care hospitals in Japan was investigated in terms of equipment, personnel, patient load, and geographic distribution. The effect of changes in the health care policy in Japan on radiotherapy structure was also examined. Material and Methods: The Japanese Society of Therapeutic Radiology and Oncology surveyed the national structure of radiation oncology in 2007. The structures of 349 designated cancer care hospitals and 372 other radiotherapy facilities were compared. Results: Respective findings for equipment and personnel at designated cancer care hospitals and other facilities included the following: linear accelerators/facility: 1.3 and 1.0; annual patients/linear accelerator: 296.5 and 175.0; and annual patient load/full-time equivalent radiation oncologist was 237.0 and 273.3, respectively. Geographically, the number of designated cancer care hospitals was associated with population size. Conclusion: The structure of radiation oncology in Japan in terms of equipment, especially for designated cancer care hospitals, was as mature as that in European countries and the United States, even though the medical costs in relation to GDP in Japan are lower. There is still a shortage of manpower. The survey data proved to be important to fully understand the radiation oncology medical care system in Japan. (orig.)

  10. Evaluation of a survey tool to measure safety climate in Australian hospital pharmacy staff.

    Science.gov (United States)

    Walpola, Ramesh L; Chen, Timothy F; Fois, Romano A; Ashcroft, Darren M; Lalor, Daniel J

    Safety climate evaluation is increasingly used by hospitals as part of quality improvement initiatives. Consequently, it is necessary to have validated tools to measure changes. To evaluate the construct validity and internal consistency of a survey tool to measure Australian hospital pharmacy patient safety climate. A 42 item cross-sectional survey was used to evaluate the patient safety climate of 607 Australian hospital pharmacy staff. Survey responses were initially mapped to the factor structure previously identified in European community pharmacy. However, as the data did not adequately fit the community pharmacy model, participants were randomly split into two groups with exploratory factor analysis performed on the first group (n = 302) and confirmatory factor analyses performed on the second group (n = 305). Following exploratory factor analysis (59.3% variance explained) and confirmatory factor analysis, a 6-factor model containing 28 items was obtained with satisfactory model fit (χ 2 (335) = 664.61 p  0.643) and model nesting between the groups (Δχ 2 (22) = 30.87, p = 0.10). Three factors (blame culture, organisational learning and working conditions) were similar to those identified in European community pharmacy and labelled identically. Three additional factors (preoccupation with improvement; comfort to question authority; and safety issues being swept under the carpet) highlight hierarchical issues present in hospital settings. This study has demonstrated the validity of a survey to evaluate patient safety climate of Australian hospital pharmacy staff. Importantly, this validated factor structure may be used to evaluate changes in safety climate over time. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey.

    Science.gov (United States)

    Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H

    2012-05-01

    This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses' work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. © 2012 Blackwell Publishing Ltd.

  12. Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey

    Science.gov (United States)

    Cai, Qian; Zhou, Yunxian; Yang, Dangan

    2017-01-01

    Introduction In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses’ knowledge on phlebotomy to provide reference for improving blood sampling practice in China. Materials and methods A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge questionnaire was designed based on the Clinical and Laboratory Standards Institute H3-A6 guidelines, combining with the situations in China. Descriptive analysis and binary logistic regression analysis were used to analyze the knowledge level and its influencing factors. Results A total of 3400 questionnaires were distributed and 3077 valid questionnaires were returned, with an effective return rate of 90.5%. The correct rates of patient identification, hand sanitization, patient assessment, tube mixing time, needle disposing location and tube labelling were greater than 90%. However, the correct rates of order of draw (15.5%), definition of an inversion (22.5%), time to release tourniquet (18.5%) and time to change tube (28.5%) were relatively low. Binary logistic regression analysis showed that the correct rates of the aforementioned four questions were mainly related to the regional distribution of the hospitals (P < 0.001). Conclusions The knowledge level on phlebotomy among Chinese nurses was found unsatisfactory in some areas. An education program on phlebotomy should be developed for Chinese nurses to improve the consistency among different regions and to enhance nurse’s knowledge level on phlebotomy. PMID:29187796

  13. Nurses' knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey.

    Science.gov (United States)

    Cai, Qian; Zhou, Yunxian; Yang, Dangan

    2018-02-15

    In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses' knowledge on phlebotomy to provide reference for improving blood sampling practice in China. A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge questionnaire was designed based on the Clinical and Laboratory Standards Institute H3-A6 guidelines, combining with the situations in China. Descriptive analysis and binary logistic regression analysis were used to analyze the knowledge level and its influencing factors. A total of 3400 questionnaires were distributed and 3077 valid questionnaires were returned, with an effective return rate of 90.5%. The correct rates of patient identification, hand sanitization, patient assessment, tube mixing time, needle disposing location and tube labelling were greater than 90%. However, the correct rates of order of draw (15.5%), definition of an inversion (22.5%), time to release tourniquet (18.5%) and time to change tube (28.5%) were relatively low. Binary logistic regression analysis showed that the correct rates of the aforementioned four questions were mainly related to the regional distribution of the hospitals (P < 0.001). The knowledge level on phlebotomy among Chinese nurses was found unsatisfactory in some areas. An education program on phlebotomy should be developed for Chinese nurses to improve the consistency among different regions and to enhance nurse's knowledge level on phlebotomy.

  14. Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012.

    Science.gov (United States)

    Hennessee, Ian; Chinkhumba, Jobiba; Briggs-Hagen, Melissa; Bauleni, Andy; Shah, Monica P; Chalira, Alfred; Moyo, Dubulao; Dodoli, Wilfred; Luhanga, Misheck; Sande, John; Ali, Doreen; Gutman, Julie; Lindblade, Kim A; Njau, Joseph; Mathanga, Don P

    2017-10-02

    With 71% of Malawians living on malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June-August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic burden of inpatient malaria care is crucial to protect

  15. The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.

    Science.gov (United States)

    Manser, Tanja; Frings, Janina; Heuser, Gregory; Mc Dermott, Fiona

    2016-01-01

    Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Copyright © 2016. Published by Elsevier GmbH.

  16. A personalized mobile patient guide system for a patient-centered smart hospital: Lessons learned from a usability test and satisfaction survey in a tertiary university hospital.

    Science.gov (United States)

    Yoo, Sooyoung; Jung, Se Young; Kim, Seok; Kim, Eunhye; Lee, Kee-Hyuck; Chung, Eunja; Hwang, Hee

    2016-07-01

    The present study focused on the design, implementation, and evaluation of a personalized mobile patient guide system that utilizes smart phones, indoor navigation technology and a hospital information system (HIS) to address the difficulties that outpatients face in finding hospital facilities, recognizing their daily treatment schedule, and accessing personalized medical and administrative information. The present study was conducted in a fully digitized tertiary university hospital in South Korea. We developed a real-time location-based outpatient guide system that consists of Bluetooth access points (APs) for indoor navigation, an Android-based guide application, a guide server, and interfaces with the HIS. A total of 33 subjects and 43 outpatients participated in the usability test (UT) and the satisfaction survey, respectively. We confirmed that the indoor navigation feature can be applied to outpatient departments with precision using a position error test. The participants in the UT completed each scenario with an average success rate of 67.4%. According to the results, we addressed the problems and made improvements to the user interface by providing users with context-based guidance information. The satisfaction rating of the system was high, with an average score of 4.0 out of 5.0, showing its utility as a patient-centered hospital service. The innovative mobile patient guide system for outpatients is feasible and can be successfully implemented to provide personalized information with high satisfaction. Additionally, the issues identified and lessons learned from our experiences regarding task scheduling, indoor navigation, and usability should be considered when developing the system. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Safety climate in Swiss hospital units: Swiss version of the Safety Climate Survey

    Science.gov (United States)

    Gehring, Katrin; Mascherek, Anna C.; Bezzola, Paula

    2015-01-01

    Abstract Rationale, aims and objectives Safety climate measurements are a broadly used element of improvement initiatives. In order to provide a sound and easy‐to‐administer instrument for the use in Swiss hospitals, we translated the Safety Climate Survey into German and French. Methods After translating the Safety Climate Survey into French and German, a cross‐sectional survey study was conducted with health care professionals (HCPs) in operating room (OR) teams and on OR‐related wards in 10 Swiss hospitals. Validity of the instrument was examined by means of Cronbach's alpha and missing rates of the single items. Item‐descriptive statistics group differences and percentage of ‘problematic responses’ (PPR) were calculated. Results 3153 HCPs completed the survey (response rate: 63.4%). 1308 individuals were excluded from the analyses because of a profession other than doctor or nurse or invalid answers (n = 1845; nurses = 1321, doctors = 523). Internal consistency of the translated Safety Climate Survey was good (Cronbach's alpha G erman = 0.86; Cronbach's alpha F rench = 0.84). Missing rates at item level were rather low (0.23–4.3%). We found significant group differences in safety climate values regarding profession, managerial function, work area and time spent in direct patient care. At item level, 14 out of 21 items showed a PPR higher than 10%. Conclusions Results indicate that the French and German translations of the Safety Climate Survey might be a useful measurement instrument for safety climate in Swiss hospital units. Analyses at item level allow for differentiating facets of safety climate into more positive and critical safety climate aspects. PMID:25656302

  18. A Survey on 100 Children with Acute Ataxia in Mofid Children Hospital Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Parvaneh Karim-Zadeh

    2003-04-01

    Full Text Available Objective: The term “Ataxia” is used to denote disturbances of the body posture and its movement that are normally controlled by the cerebellum. frontal lobes and the posterior columns of the spinal cord. The initial symptom and the most prominent feature of ataxia is abnormal gait which is characterized by lurching and wide base walking. Knowing that, the acute ataxia is among those problems that brings very soon the child to pediatrics neurology department and in view of lack of any survey in this neid in our country, we decided to investigate the etiology of acute ataxia in Islamic Republic of Iran. Materials & Methods: Our patients were recruited from 100 children who were brought to neurology service of Mofid children hospital with the chief complaint of acute ataxia over 2 years period. (sep 2001 to sep 2003. All of those 100 patients were admitted and required investigations were performed. Results: Results of our workup revealed that the most common cause of acute ataxia is acute cerebellar one, which all of them preceded by viral febrile illness. The second frequent cause of acute. Ataxia is due to drug intoxication, which commonly was observed between 2 – 4 years period. Conclusion: The remaining etiologies in descending frequency were as follow, Infectious polyneuropathy, Migraine, Opsoclonus – Myoclonus, Brain tumor, ADEM,MS and Epilepsy.

  19. Maternal healthcare needs assessment survey at Rabia Balkhi Hospital in Kabul, Afghanistan.

    Science.gov (United States)

    Khorrami, Homa; Karzai, Fatima; Macri, Charles J; Amir, Azizullah; Laube, Douglas

    2008-06-01

    Since the Department of Health and Human Services chose Rabia Balkhi Hospital (RBH) in Kabul, Afghanistan, as a site for intervention in 2002, the status of women's health there has been of interest. This study created a tool to assess accessibility and quality of care of women admitted from May to July, 2005. A 39-item questionnaire was created in English and translated into Dari. Hospital staff administered the survey to 292 women admitted to RBH for obstetric and gynecological complaints. Approximately 40% of the women traveled between 1 and 5 hours to reach RBH. Only 54% (158/292) of women reported having their blood pressure monitored during their pregnancy. About one-third of women reported that they had never received an immunization. This survey tool ascertained that women who received care at RBH traveled great lengths to reach the facility. Preventative measures such as blood pressure checks and immunizations are areas that need improvement.

  20. Appropriateness of Antibiotic Prescribing in U. S. Children’s Hospitals: A National Point Prevalence Survey

    Science.gov (United States)

    Tribble, Alison; Lee, Brian; Handy, Lori; Gerber, Jeffrey S; Hersh, Adam L; Kronman, Matthew; Terrill, Cindy; Newland, Jason

    2017-01-01

    Abstract Background Multiple studies estimate that inappropriate antibiotic prescribing ranges from 30–50% in hospitalized patients, but few have included pediatric patients. Pediatric studies characterizing inappropriate prescribing are needed to target and improve antimicrobial stewardship program (ASP) efforts. Methods Cross-sectional analysis of antimicrobial prescribing at 30 U.S. children’s hospitals. Participating hospitals were academic, tertiary care hospitals in the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) collaborative. Subjects were children 0–17 years with an active antibiotic order at 0800 on a single day during three consecutive calendar quarters (Q3 2016 – Q1 2017). Each hospital’s ASP used a standardized survey to collect data on antibiotic orders and evaluate appropriateness. Data were pooled from the three surveys. The primary outcome was the pooled estimate for the percentage of prescriptions classified as inappropriate. Secondary outcomes were pooled estimates for indication, reason for inappropriate use, and ASP review status for each antibiotic. Results Of 19,598 children hospitalized on survey days, 6,922 (35%) had ≥1 active antibiotic order. Median age of children receiving antibiotics was 3.7 years (0.5, 10.9). Figures 1 and 2 show the most common antibiotics and indications. Of all antibiotic orders, 1,514 (15%) were classified as inappropriate, and 19% of patients with antibiotic orders had at least one inappropriate order. The most common reasons for inappropriate use were bug-drug mismatch (26%), surgical prophylaxis > 24 hours (18%) and unnecessary duplicate therapy (12%). ASPs would not have routinely reviewed 50% of all inappropriate orders. An additional 22% of inappropriate orders were for antibiotics typically reviewed by ASPs, but were yet to be reviewed at the time of the survey. Conclusion Across 30 children’s hospitals, approximately 1 in 3 hospitalized children is receiving an antibiotic

  1. Hospital-based surveillance of enteric parasites in Kolkata

    Directory of Open Access Journals (Sweden)

    Ghosh Mrinmoy

    2009-06-01

    Full Text Available Abstract Background Diarrhoea is the second leading cause of illness and death in developing countries and the second commonest cause of death due to infectious diseases among children under five in such countries. Parasites, as well as bacterial and viral pathogens, are important causes of diarrhoea. However, parasitic infections are sometimes overlooked, leading after a period of time to an uncertain aetiology. In this paper we report the prevalence of Giardia lamblia, Entamoeba histolytica and Cryptosporidium sp. in and around Kolkata. Findings A hospital-based laboratory surveillance study was conducted among the patients admitted between November 2007 and October 2008 to the Infectious Diseases (ID Hospital (Population = 1103 with diarrhoeal complaints. Of the 1103 samples collected, 147 were positive for Giardia lamblia, 84 for Cryptosporidium sp. and 51 for Entamoeba histolytica. For all these parasites there was a high rate of mixed infection with common enteric viruses and bacteria such as Rotavirus, Vibrio cholerae and Shigella sp. There were also cases of co-infection with all other diarrheogenic pathogens. The age group ≥ 5 years had the highest prevalence of parasites whereas the age group >5 – 10 years was predominantly infected with Giardia lamblia (p =10 – 20 years could also be considered at risk for G. lamblia (p = 0.009; OR = 2.231; 95% CI = 1.223 – 4.067. Month-wise occurrence data showed an endemic presence of G. lamblia whereas Cryptosporidium sp. and E. histolytica occurred sporadically. The GIS study revealed that parasites were more prevalent in areas such as Tangra, Tiljala and Rajarhat, which are mainly slum areas. Because most of the population surveyed was in the lower income group, consumption of contaminated water and food could be the major underlying cause of parasitic infestations. Conclusion This study provides important information on the occurrence and distribution of three important intestinal

  2. Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC).

    Science.gov (United States)

    Chen, I-Chi; Li, Hung-Hui

    2010-06-07

    Patient safety is a critical component to the quality of health care. As health care organizations endeavour to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. In this research, the authors use the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire to assess the culture of patient safety in Taiwan and attempt to provide an explanation for some of the phenomena that are unique in Taiwan. The authors used HSOPSC to measure the 12 dimensions of the patient safety culture from 42 hospitals in Taiwan. The survey received 788 respondents including physicians, nurses, and non-clinical staff. This study used SPSS 15.0 for Windows and Amos 7 software tools to perform the statistical analysis on the survey data, including descriptive statistics and confirmatory factor analysis of the structural equation model. The overall average positive response rate for the 12 patient safety culture dimensions of the HSOPSC survey was 64%, slightly higher than the average positive response rate for the AHRQ data (61%). The results showed that hospital staff in Taiwan feel positively toward patient safety culture in their organization. The dimension that received the highest positive response rate was "Teamwork within units", similar to the results reported in the US. The dimension with the lowest percentage of positive responses was "Staffing". Statistical analysis showed discrepancies between Taiwan and the US in three dimensions, including "Feedback and communication about error", "Communication openness", and "Frequency of event reporting". The HSOPSC measurement provides evidence for assessing patient safety culture in Taiwan. The results show that in general, hospital staffs in Taiwan feel positively toward patient safety culture within their organization. The existence of discrepancies between the US data and the Taiwanese data suggest that cultural uniqueness should be taken into

  3. Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey

    OpenAIRE

    Cai, Qian; Zhou, Yunxian; Yang, Dangan

    2017-01-01

    Introduction In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses’ knowledge on phlebotomy to provide reference for improving blood sampling practice in China. Materials and methods A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge qu...

  4. Home-based intermediate care program vs hospitalization

    Science.gov (United States)

    Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

    2008-01-01

    OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

  5. [Reality of treatment in psychotherapy: Results of a survey of German psychiatric hospitals].

    Science.gov (United States)

    Laux, G; Sander, K; Artmann, S; Dreher, J; Lenz, J; Hauth, I

    2015-05-01

    Since the introduction of the qualification as specialist for psychiatry and psychotherapy, in addition to psychopharmacotherapy psychotherapy is an integral component of the treatment of mentally ill people. A survey was carried out to evaluate the reality of clinical routine use of psychotherapy in German psychiatric hospitals. Between October 2011 and March 2012 German hospitals of psychiatry and psychotherapy were contacted by the head organization, the conference of national directors (Bundesdirektorenkonferenz), to participate in a survey regarding the application of psychotherapy in the real clinical world of daily treatment. With an anonymous questionnaire, data were requested as either a printed form or online version. Data from 25 psychiatric hospitals in the year 2010 could be analysed (average number of beds 300 of which 53 were for psychosomatic/psychotherapeutic patients) and a total of 87,000 inpatients were treated whereby 34 % were diagnosed as F1 addictive disorders and 24 % as F3 affective disorders. More than 80 % of the hospitals applied group therapies of relaxation, cognitive behavior therapy, social competence training and specific techniques, such as dialectic-behavior therapy. As individual treatment methods, patients with depressive disorders were treated with cognitive behavior therapy, interpersonal psychotherapy or psychodynamic therapy in more than 50 % of the cases. Relaxation techniques were offered in most cases by the nursing staff, behavior therapy by psychologists and physicians and psychodynamic therapy mainly by psychiatrists.

  6. Current status and perceived needs of information technology in Critical Access Hospitals: a survey study

    Directory of Open Access Journals (Sweden)

    George Demiris

    2007-01-01

    Full Text Available The US Congress established the designation of Critical Access Hospitals in 1997, recognising rural hospitals as vital links to health for rural and underserved populations. The intent of the reimbursement system is to improve financial performance, thereby reducing hospital closures. Informatics applications are thought to be tools that can enable the sustainability of such facilities. The aim of this study is to identify the current use of information and communication technology in Critical Access Hospitals, and to assess their readiness and receptiveness for the use of new software and hardware applications and their perceived information technology (IT needs. A survey was mailed to the administrators of all Critical Access Hospitals in one US state (Missouri and a reminder was mailed a few weeks later. Twenty-seven out of 33 surveys were filled out and returned (response rate 82%. While most respondents (66.7% stated that their employees have been somewhat comfortable in using new technology, almost 15% stated that their employees have been somewhat uncomfortable. Similarly, almost 12% of the respondents stated that they themselves felt somewhat uncomfortable introducing new technology. While all facilities have computers, only half of them have a specific IT plan. Findings indicate that Critical Access Hospitals are often struggling with lack of resources and specific applications that address their needs. However, it is widely recognised that IT plays an essential role in the sustainability of their organisations. The study demonstrates that IT applications have to be customised to address the needs and infrastructure of the rural settings in order to be accepted and properly utilised.

  7. [Team approaches to critical bleeding (massive bleeding and transfusion) - chairmen's introductory remarks. Questionnaire survey on current status of hospital clinical laboratories evaluating critical hemorrhage].

    Science.gov (United States)

    Kino, Shuichi; Suwabe, Akira

    2014-12-01

    In 2007, "the Guidelines for Actions against Intraoperative Critical Hemorrhage" were established by the Japanese Society of Anaesthesiologists and the Japanese Society of Blood transfusion and Cell Therapy. The documentation of in-hospital procedures for critical hemorrhage, especially about how to select RBC units, has widely standardized hospital practice. Patients with intraoperative critical hemorrhage sometimes suffer from massive blood loss. In this situation, some patients develop coagulopathy. To treat them, we need to evaluate their coagulation status based on laboratory test results. So, we performed a nationwide questionnaire survey on the current status of hospital clinical laboratories evaluating critical hemorrhage. From the results of this survey, it was recommended that central hospital laboratories should try to reduce the turn-around time required to test for coagulation parameters as much as possible for appropriate substitution therapy. (Review).

  8. A Comparison of Web-Based and Paper-Based Survey Methods: Testing Assumptions of Survey Mode and Response Cost

    Science.gov (United States)

    Greenlaw, Corey; Brown-Welty, Sharon

    2009-01-01

    Web-based surveys have become more prevalent in areas such as evaluation, research, and marketing research to name a few. The proliferation of these online surveys raises the question, how do response rates compare with traditional surveys and at what cost? This research explored response rates and costs for Web-based surveys, paper surveys, and…

  9. Serving high-risk foods in a high-risk setting: survey of hospital food service practices after an outbreak of listeriosis in a hospital.

    Science.gov (United States)

    Cokes, Carolyn; France, Anne Marie; Reddy, Vasudha; Hanson, Heather; Lee, Lillian; Kornstein, Laura; Stavinsky, Faina; Balter, Sharon

    2011-04-01

    Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies and practices after a listeriosis outbreak occurred in a NYC hospital. From August through October 2008, a listeriosis outbreak in a NYC hospital was investigated. From February through April 2009, NYC's 61 acute-care hospitals were asked to participate in a telephone survey regarding food safety practices and policies, specifically service of high-risk foods to patients at increased risk for listeriosis. Five patients with medical conditions that put them at high risk for listeriosis had laboratory-confirmed Listeria monocytogenes infection. The Listeria outbreak strain was isolated from tuna salad prepared in the hospital. Fifty-four (89%) of 61 hospitals responded to the survey. Overall, 81% of respondents reported serving ready-to-eat deli meats to patients, and 100% reported serving prepared ready-to-eat salads. Pregnant women, patients receiving immunosuppressive drugs, and patients undergoing chemotherapy were served ready-to-eat deli meats at 77%, 59%, and 49% of hospitals, respectively, and were served prepared ready-to-eat salads at 94%, 89%, and 73% of hospitals, respectively. Only 4 (25%) of 16 respondents reported having a policy that ready-to-eat deli meats must be heated until steaming hot before serving. Despite the potential for severe outcomes of Listeria infection among hospitalized patients, the majority of NYC hospitals had no food preparation policies to minimize risk. Hospitals should implement policies to avoid serving high-risk foods to patients at risk for listeriosis.

  10. Problem based Learning in surveying Education

    DEFF Research Database (Denmark)

    Enemark, Stig

    The challenge of the future will be that the only constant is change. Therefore, the educational base must be flexible. The graduates must possess skills to adapt to a rapidly changing labour market and they must possess skills to deal with even the unknown problems of the future. The point is...... that opportunity. The basis principles of this educational model are presented using the surveying programme at Aalborg University as an example....

  11. From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

    Science.gov (United States)

    Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J

    2006-12-01

    To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.

  12. Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey

    Science.gov (United States)

    Keyvanara, Mahmoud; Sajadi, Haniye Sadat

    2015-01-01

    Background: Changes in modern societies develop the perception that the external environment is essential in organization’s practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. Methods: A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. Results: The mean score of hospitals’ social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals’ ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. Conclusion: It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals’ social responsibility level, especially through concentrating on their staff’s working environment. PMID:26340391

  13. French hospital nurses' opinion about euthanasia and physician-assisted suicide: a national phone survey.

    Science.gov (United States)

    Bendiane, M K; Bouhnik, A-D; Galinier, A; Favre, R; Obadia, Y; Peretti-Watel, P

    2009-04-01

    Hospital nurses are frequently the first care givers to receive a patient's request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses' opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. A phone survey conducted among a random national sample of 1502 French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call "good" euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia.

  14. Incidences and variations of hospital acquired venous thromboembolism in Australian hospitals: a population-based study.

    Science.gov (United States)

    Assareh, Hassan; Chen, Jack; Ou, Lixin; Hillman, Ken; Flabouris, Arthas

    2016-09-22

    Data on hospital-acquired venous thromboembolism (HA-VTE) incidence, case fatality rate and variation amongst patient groups and health providers is lacking. We aim to explore HA-VTE incidences, associated mortality, trends and variations across all acute hospitals in New South Wales (NSW)-Australia. A population-based study using all admitted patients (aged 18-90 with a length of stay of at least two days and not transferred to another acute care facility) in 104 NSW acute public and private hospitals during 2002-2009. Poisson mixed models were used to derive adjusted rate ratios (IRR) in presence of patient and hospital characteristics. Amongst, 3,331,677 patients, the incidence of HA-VTE was 11.45 per 1000 patients and one in ten who developed HA-VTE died in hospital. HA-VTE incidence, initially rose, but subsequently declined, whereas case fatality rate consistently declined by 22 % over the study period. Surgical patients were 128 % (IRR = 2.28, 95 % CI: 2.19-2.38) more likely to develop HA-VTE, but had similar case fatality rates compared to medical patients. Private hospitals, in comparison to public hospitals had a higher incidence of HA-VTE (IRR = 1.76; 95 % CI: 1.42-2.18) for medical patients. However, they had a similar incidence (IRR = 0.91; 95 % CI: 0.75-1.11), but a lower mortality (IRR = 0.59; 95 % CI: 0.47-0.75) amongst surgical patients. Smaller public hospitals had a lower HA-VTE incidence rate compared to larger hospitals (IRR  1.71). Hospitals with a lower reported HA-VTE incidence tended to have a higher HA-VTE case fatality rate. Despite the decline in HA-VTE incidence and case fatality, there were large variations in incidents between medical and surgical patients, public and private hospitals, and different hospital groups. The causes of such differences warrant further investigation and may provide potential for targeted interventions and quality improvement initiatives.

  15. DYSELECTROLYTEMIA IN ELDERLY: A HOSPITAL BASED STUDY

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    Tanushree

    2016-03-01

    Full Text Available INTRODUCTION Dyselectrolytemia is a common problem affecting elderly hospitalised patients. Although hypo/hypernatremia is the most common electrolyte abnormality found in elderly, abnormalities in other electrolytes may also occur in various settings. Information regarding the pattern of electrolyte abnormalities in elderly is lacking in this part of the country. With this background the following case control study was taken up with the following aims and objectives. OBJECTIVES • To study the various patterns of dyselectrolytemia in elderly and compare them with young. • To evaluate and compare the various aetiological factors and comorbid conditions involved in the occurrence of electrolyte abnormalities in these groups of patients. RESULTS The mean age of the study population was 66.174 years (SD- 6.512 years and of the control group was 41.94 years (SD - 10.924 years. Hyponatraemia was the most common electrolyte abnormality encountered in both the groups (57% vs. 60%, p- 0.61. The incidence of hyperkalaemia was significantly higher in the older age group (19.5% vs. 11.5%, p-0.03. Also, in the elderly, the presence of abnormalities in more than one electrolyte level was significantly higher than the young (25.5% vs. 14%, p -0.005. The average length of hospital stay in the elderly was 10.05 days (SD- 4.40 days whereas in the young was 6.35 days (SD- 3.27 days, p <0.0001. The mortality rate was also significantly higher in the elderly group (16% vs. 3.5%, p<0.0001. CONCLUSION Dyselectrolytemia is a common pathological condition encountered in the elderly population which is associated with a very high morbidity and mortality when compared with the young. Hence, elderly patients particularly with associated comorbid conditions should be screened routinely for the presence of associated electrolyte disturbances.

  16. Physicians’ knowledge, attitudes, and perceptions concerning antibiotic resistance: a survey in a Ghanaian tertiary care hospital

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    Appiah-Korang Labi

    2018-02-01

    Full Text Available Abstract Background Understanding the knowledge, attitudes and practices of physicians towards antibiotic resistance is key to developing interventions aimed at behavior change. The survey aimed to investigate physicians’ knowledge and attitudes towards antibiotic resistance in a tertiary-care hospital setting in Ghana. Methods We conducted a cross-sectional respondent-driven survey using a 40-item, anonymous, voluntary, traditional paper-and-pencil self-administered questionnaire among 159 physicians at Korle-Bu Teaching Hospital. Single and multi-factor analysis were conducted to assess the study objectives. Results The survey was completed by 159 of 200 physicians (response rate of 79.5%. Of physicians, 30.1% (47/156 perceived antibiotic resistance as very important global problem, 18.5% (29/157 perceived it as very important national problem and only 8.9% (14/157 thought it as a very important problem in their hospital. Methicillin resistant Staphylococcus aureus was the most known about antibiotic resistant bacteria of public health importance followed by extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem resistant Enterobacteriaceae (CRE and vancomycin resistant enterococci (VRE. In multiple logistic regression analysis, senior physicians were nearly 3 times more likely to know about CRE than junior physicians. The odds of knowing about VRE increased over 4.5 times from being a junior to becoming senior physician. Among junior physicians, age had no associated effect on their knowledge of VRE or CRE. Conclusions Physicians in this survey showed variable knowledge and perceptions on antibiotic resistance. Introducing educational programs on antibiotic resistance would be a useful intervention and should focus on junior physicians.

  17. Hospital Based Customization of a Medical Information System

    Science.gov (United States)

    Rath, Marilyn A.; Ferguson, Julie C.

    1983-01-01

    A Medical Information System must be current if it is to be a viable adjunct to patient care within a hospital setting. Hospital-based customization provides a means of achieving this timeliness with maximum user satisfaction. It, however, requires a major commitment in personnel time as well as additional software and training expenses. The enhanced control of system modifications and overall flexibility in planning the change process result in enthusiastic support of this approach by many hospitals. The key factors for success include careful selection of local personnel with adequate vendor support, extensive QA control, thorough auditing/validation and direct user involvement.

  18. Organizational Strategies to Implement Hospital Pressure Ulcer Prevention Programs: Findings from a National Survey

    Science.gov (United States)

    SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.

    2017-01-01

    Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972

  19. Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.

    Science.gov (United States)

    Soban, Lynn M; Kim, Linda; Yuan, Anita H; Miltner, Rebecca S

    2017-09-01

    To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes. Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals. Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance. The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  20. Hospital survey on patient safety culture: psychometric analysis on a Scottish sample.

    Science.gov (United States)

    Sarac, Cakil; Flin, Rhona; Mearns, Kathryn; Jackson, Jeanette

    2011-10-01

    To investigate the psychometric properties of the Hospital Survey on Patient Safety Culture on a Scottish NHS data set. The data were collected from 1969 clinical staff (estimated 22% response rate) from one acute hospital from each of seven Scottish Health boards. Using a split-half validation technique, the data were randomly split; an exploratory factor analysis was conducted on the calibration data set, and confirmatory factor analyses were conducted on the validation data set to investigate and check the original US model fit in a Scottish sample. Following the split-half validation technique, exploratory factor analysis results showed a 10-factor optimal measurement model. The confirmatory factor analyses were then performed to compare the model fit of two competing models (10-factor alternative model vs 12-factor original model). An S-B scaled χ(2) square difference test demonstrated that the original 12-factor model performed significantly better in a Scottish sample. Furthermore, reliability analyses of each component yielded satisfactory results. The mean scores on the climate dimensions in the Scottish sample were comparable with those found in other European countries. This study provided evidence that the original 12-factor structure of the Hospital Survey on Patient Safety Culture scale has been replicated in this Scottish sample. Therefore, no modifications are required to the original 12-factor model, which is suggested for use, since it would allow researchers the possibility of cross-national comparisons.

  1. Nurse awareness of clinical research: a survey in a Japanese University Hospital

    Science.gov (United States)

    2014-01-01

    Background Clinical research plays an important role in establishing new treatments and improving the quality of medical practice. Since the introduction of the concept of clinical research coordinators (CRC) in Japan, investigators and CRC work as a clinical research team that coordinates with other professionals in clinical trials leading to drug approval (registration trials). Although clinical nurses collaborate with clinical research teams, extended clinical research teams that include clinical nurses may contribute to the ethical and scientific pursuit of clinical research. Methods As knowledge of clinical research is essential for establishing an extended clinical research team, we used questionnaires to survey the knowledge of clinical nurses at Tokushima University Hospital. Five-point and two-point scales were used. Questions as for various experiences were also included and the relationship between awareness and experiences were analyzed. Results Among the 597 nurses at Tokushima University Hospital, 453 (75.9%) responded to the questionnaires. In Japan, registration trials are regulated by pharmaceutical affairs laws, whereas other types of investigator-initiated research (clinical research) are conducted based on ethical guidelines outlined by the ministries of Japan. Approximately 90% of respondents were aware of registration trials and clinical research, but less than 40% of the nurses were aware of their difference. In clinical research terminology, most respondents were aware of informed consent and related issues, but ≤50% were aware of other things, such as the Declaration of Helsinki, ethical guidelines, Good Clinical Practice, institutional review boards, and ethics committees. We found no specific tendency in the relationship between awareness and past experiences, such as nursing patients who were participating in registration trials and/or clinical research or taking a part in research involving patients as a nursing student or a nurse

  2. What Do Patients Want? Survey of Patient Desires for Education in an Urban University Hospital

    Directory of Open Access Journals (Sweden)

    Thomas Seibert

    2014-11-01

    Full Text Available Introduction: This study examines the emergency department (ED waiting room (WR population’s knowledge about the ED process and hospital function and explores the types of educational materials that might appeal to patients and their companions in an ED waiting room. Our goal was to identify potential high-impact opportunities for patient education. Methods: A 32-question survey about demographics, usage of primary care physicians (PCP, understanding of the ED and triage process, desire to know about delays, health education and understanding of teaching hospitals was offered to all qualified individuals. Results: Five hundred and forty-four surveys were returned. Fifty-five percent reported having a PCP, of which 53% (29% of all WR patients called a PCP prior to coming to the ED. It was found that 51.2% can define triage; 51% as an acuity assessment and 17% as a vital signs check. Sixty-nine percent knew why patients were seen according to triage priority. Seventy-two percent wanted to know about delays, yet only 25% wanted to know others’ wait times. People wanted updates every 41 minutes and only three percent wanted a physician to do this. Forty-one percent wanted information on how the ED functions, 60% via handouts and 43% via video. Information on updates and common medical emergencies is significantly more important than material on common illnesses, finding a PCP, or ED function (p<0.05. Median estimated time for medical workup ranged from 35 minutes for radiographs, to one hour for lab results, computed tomography, specialist consult, and admission. Sixty-nine percent knew the definition of a teaching hospital and of those, 87% knew they were at a teaching hospital. Subgroup analysis between racial groups showed significantly reduced knowledge of the definitions of triage and teaching hospitals and significantly increased desire for information on ED function in minority groups (p<0.05. Conclusion: The major findings in this study

  3. Psychosocial Care for Injured Children: Worldwide Survey among Hospital Emergency Department Staff.

    Science.gov (United States)

    Alisic, Eva; Hoysted, Claire; Kassam-Adams, Nancy; Landolt, Markus A; Curtis, Sarah; Kharbanda, Anupam B; Lyttle, Mark D; Parri, Niccolò; Stanley, Rachel; Babl, Franz E

    2016-03-01

    To examine emergency department (ED) staff's knowledge of traumatic stress in children, attitudes toward providing psychosocial care, and confidence in doing so, and also to examine differences in these outcomes according to demographic, professional, and organizational characteristics, and training preferences. We conducted an online survey among staff in ED and equivalent hospital departments, based on the Psychological First Aid and Distress-Emotional Support-Family protocols. Main analyses involved descriptive statistics and multiple regressions. Respondents were 2648 ED staff from 87 countries (62.2% physicians and 37.8% nurses; mean years of experience in emergency care was 9.5 years with an SD of 7.5 years; 25.2% worked in a low- or middle-income country). Of the respondents, 1.2% correctly answered all 7 knowledge questions, with 24.7% providing at least 4 correct answers. Almost all respondents (90.1%) saw all 18 identified aspects of psychosocial care as part of their job. Knowledge and confidence scores were associated with respondent characteristics (eg, years of experience, low/middle vs high-income country), although these explained no more than 11%-18% of the variance. Almost all respondents (93.1%) wished to receive training, predominantly through an interactive website or one-off group training. A small minority (11.1%) had previously received training. More education of ED staff regarding child traumatic stress and psychosocial care appears needed and would be welcomed. Universal education packages that are readily available can be modified for use in the ED. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Psychological consequences of aggression in pre-hospital emergency care: cross sectional survey.

    Science.gov (United States)

    Bernaldo-De-Quirós, Mónica; Piccini, Ana T; Gómez, M Mar; Cerdeira, Jose C

    2015-01-01

    Pre-hospital emergency care is a particularly vulnerable setting for workplace violence. However, there is no literature available to date on the psychological consequences of violence in pre-hospital emergency care. To evaluate the psychological consequences of exposure to workplace violence from patients and those accompanying them in pre-hospital emergency care. A retrospective cross-sectional study. 70 pre-hospital emergency care services located in Madrid region. A randomized sample of 441 health care workers (135 physicians, 127 nurses and 179 emergency care assistants). Data were collected from February to May 2012. The survey was divided into four sections: demographic/professional information, level of burnout determined by Maslach Burnout Inventory (MBI), mental health status using General Health Questionnaire (GHQ-28) and frequency and type of violent behaviour experienced by staff members. The health care professionals who had been exposed to physical and verbal violence presented a significantly higher percentage of anxiety, emotional exhaustion, depersonalization and burnout syndrome compared with those who had not been subjected to any aggression. Frequency of verbal violence (more than five times) was related to emotional exhaustion and depersonalization. Type of violence (i.e. physical aggression) is especially related to high anxiety levels and frequency of verbal aggression is associated with burnout (emotional exhaustion and depersonalization). Psychological counselling should be made available to professional staff who have been subjected to physical aggression or frequent verbal violence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Questionnaire survey of working relationships between nurses and doctors in University Teaching Hospitals in Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Adebamowo Clement A

    2006-02-01

    Full Text Available Abstract Background Smooth working relationships between nurses and doctors are necessary for efficient health care delivery. However, previous studies have shown that this is often absent with negative impact on the quality of health care delivery. In 2002, we studied factors that affect nurse-doctor working relationships in University Teaching Hospitals (UTH in Southern Nigeria in order to characterize it and identify managerial and training needs that might be used to improve it. Method Questionnaire survey of doctors and nurses working in four UTH in Southern Nigeria was done in 2002. The setting and subjects were selected by random sampling procedures. Information on factors in domains of work, union activities, personnel and hospital management were studied using closed and open-ended questionnaires. Results Nurse-doctor working relationships were statistically significantly affected by poor after-work social interaction, staff shortages, activist unionism, disregard for one's profession, and hospital management and government policies. In general, nurses had better opinion of doctors' work than doctors had about nurses' work. Conclusion Working relationships between doctors and nurses need to be improved through improved training and better working conditions, creation of better working environment, use of alternative methods of conflict resolution and balanced hospital management and government policies. This will improve the retention of staff, job satisfaction and efficiency of health care delivery in Nigeria.

  6. Prevalence and risk factors of agitation in newly hospitalized schizophrenia patients in China: An observational survey.

    Science.gov (United States)

    Mi, Weifeng; Zhang, Suzhen; Liu, Qi; Yang, Fude; Wang, Yong; Li, Tao; Mei, Qiyi; He, Hongbo; Chen, Zhiyu; Su, Zhonghua; Liu, Tiebang; Xie, Shiping; Tan, Qingrong; Zhang, Jinbei; Zhang, Congpei; Sang, Hong; Chen, Wenhao; Shi, Le; Li, Lingzhi; Shi, Ying; Guo, Lihua; Zhang, Hongyan; Lu, Lin

    2017-07-01

    This multi-center observational study investigated the prevalence of agitation in newly hospitalized schizophrenia patients in China and its potential risk factors. It was performed in 2014 and covered 14 hospitals. Newly hospitalized patients with schizophrenia or suspected schizophrenia who met the diagnostic criteria of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, were recruited. Agitation and related risk factors were evaluated by a questionnaire designed for the survey. General demographic data, disease characteristics, scores on schizophrenia rating scales and agitation rating scales (e.g., Positive and Negative Syndrome Scale-Excited Component [PANSS-EC] and Behavioral Activity Rating Scale [BARS]) were collected. Among the 1512 patients screened in the study, 1400 (92.59%) were eligible. According to the PANSS-EC and BARS, the prevalence of agitation was 60.92% (853 of 1400) and 59.00% (826 of 1400), respectively. The overall prevalence of agitation was 47.50% (665 of 1400). The most important risk factor of agitation was being aggressive at baseline (Modified Overt Aggression Scale score ≥4, odds ratio=6.54; 95% confidence interval=4.93-8.69). Other risk factors included a history of aggressive behavior, northern region of residence, involuntary hospitalization, disease severity, low level of education, living alone, being unemployed or retired. Copyright © 2017. Published by Elsevier B.V.

  7. Research Survey on the Therapeutic Use of Horticulture in Welfare Institutions and Psychiatric Hospitals in Fukuoka Prefecture, Japan

    OpenAIRE

    松尾, 英輔; 藤木, 雄二; 藤原, 勝紀; Matsuo, Eisuke; Fujiki, Yuji; Fujiwara, Katsunori

    1997-01-01

    A survey was conducted using a mailed questionnaire to investigate the use of horticulture in welfare institutions and psychiatric hospitals in Fukuoka Prefecture. Approximately 70% of the 230 surveyed institutions and hospitals responded. Sixty-two% of the responding institutions had the clients engaged in horticulture. All of them reported having sites for horticultural activities, including container gardening. It was found that farms and flower gardens were the most commonly used sites. H...

  8. Orthopedic Implant Value Drivers: A Qualitative Survey Study of Hospital Purchasing Administrators.

    Science.gov (United States)

    Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

    2015-01-01

    Osteoarthritis (OA) is a chronic, degenerative disease that is highly prevalent in the population, yet the factors that affect purchasing decisions related to this condition are poorly understood. A questionnaire was developed and administered to hospital executives across North America to determine the factors that affect purchasing decisions related to OA. Thirty-four individuals participated in the survey. Clinical evidence and cost effectiveness were deemed to be the most important factors in the process of making purchasing decisions. The most important considerations for adopting new technology were whether there was sufficient evidence in the literature, followed by thoughts of key opinion leaders, and cost of intervention/device. Ongoing research is still needed, but the current study allowed us to identify some trends in the data, providing new insight on how hospital purchasing decisions are made, which could have an immediate impact on those currently involved with making these decisions.

  9. Smoking in hospital: a survey of attitudes of staff, patients, and visitors.

    Science.gov (United States)

    Garratt, D J; Gough, N A; Taylor, E J; Banks, M H; Sönksen, P H

    1978-01-01

    A survey was carried out on attitudes to smoking in hospital. Analysis of 411 interviews showed that the majority (64%) of those questioned approved of some restrictions on patients smoking in the wards. Eighteen per cent would have liked to see a complete ban on smoking, while an identical number favoured no restrictions at all. Smoking habit influenced response; only 8% of smokers, compared with 25% of non-smokers, would have liked to see a total ban on smoking. Attitudes to smoking varied according to the status of the persons interviewed; only 6% of visitors and 7% of nurses approved of a complete ban on smoking, compared with 32% of medical students and 27% of doctors. The results suggest that the introduction of smoking and non-smoking areas in hospital wards would be approved by the majority of patients, staff, and visitors. PMID:711983

  10. Designing HIGH-COST medicine: hospital surveys, health planning, and the paradox of progressive reform.

    Science.gov (United States)

    Perkins, Barbara Bridgman

    2010-02-01

    Inspired by social medicine, some progressive US health reforms have paradoxically reinforced a business model of high-cost medical delivery that does not match social needs. In analyzing the financial status of their areas' hospitals, for example, city-wide hospital surveys of the 1910s through 1930s sought to direct capital investments and, in so doing, control competition and markets. The 2 national health planning programs that ran from the mid-1960s to the mid-1980s continued similar strategies of economic organization and management, as did the so-called market reforms that followed. Consequently, these reforms promoted large, extremely specialized, capital-intensive institutions and systems at the expense of less complex (and less costly) primary and chronic care. The current capital crisis may expose the lack of sustainability of such a model and open up new ideas and new ways to build health care designed to meet people's health needs.

  11. Working after a tornado: a survey of hospital personnel in Joplin, Missouri.

    Science.gov (United States)

    Charney, Rachel; Rebmann, Terri; Flood, Robert G

    2014-01-01

    In 2011, an EF5 tornado hit Joplin, MO, requiring complete evacuation of 1 hospital and a patient surge to another. We sought to assess the resilience of healthcare workers in these hospitals as measured by number reporting to work, willingness to work, personal disaster preparedness, and childcare responsibilities following the disaster. In May 2013, a survey was distributed to healthcare workers at both Joplin hospitals that asked them to report their willingness to work and personal disaster preparedness following various disaster scenarios. For those with childcare responsibilities, scheduling, costs, and impact of hypothetical alternative childcare programs were considered in the analyses. A total of 1,234 healthcare workers completed the survey (response rate: 23.4%). Most (87.8%) worked the week following the Joplin tornado. Healthcare workers report more willingness to work during a future earthquake or tornado compared to their pre-Joplin tornado attitudes (86.2 vs 88.4%, t=-4.3, ptornado personal disaster preparedness, but only preevent preparedness was a significant predictor of postevent preparedness. Nearly half (48.5%, n=598) had childcare responsibilities; 61% (n=366) had childcare needs the week of the tornado, and 54% (n=198) required the use of alternative childcare. If their hospital had provided alternative childcare, 51% would have used it and 42% felt they would have been more willing to report to work. Most healthcare workers reported to work following this disaster, demonstrating true resilience. Disaster planners should be aware of these perceptions as they formulate their own emergency operation plans.

  12. Factors Associated With Burnout Among US Hospital Clinical Pharmacy Practitioners: Results of a Nationwide Pilot Survey.

    Science.gov (United States)

    Jones, G Morgan; Roe, Neil A; Louden, Les; Tubbs, Crystal R

    2017-12-01

    Background: In health care, burnout has been defined as a psychological process whereby human service professionals attempting to positively impact the lives of others become overwhelmed and frustrated by unforeseen job stressors. Burnout among various physician groups who primarily practice in the hospital setting has been extensively studied; however, no evidence exists regarding burnout among hospital clinical pharmacists. Objective: The aim of this study was to characterize the level of and identify factors independently associated with burnout among clinical pharmacists practicing in an inpatient hospital setting within the United States. Methods: We conducted a prospective, cross-sectional pilot study utilizing an online, Qualtrics survey. Univariate analysis related to burnout was conducted, with multivariable logistic regression analysis used to identify factors independently associated with the burnout. Results: A total of 974 responses were analyzed (11.4% response rate). The majority were females who had practiced pharmacy for a median of 8 years. The burnout rate was high (61.2%) and largely driven by high emotional exhaustion. On multivariable analysis, we identified several subjective factors as being predictors of burnout, including inadequate administrative and teaching time, uncertainty of health care reform, too many nonclinical duties, difficult pharmacist colleagues, and feeling that contributions are underappreciated. Conclusions: The burnout rate of hospital clinical pharmacy providers was very high in this pilot survey. However, the overall response rate was low at 11.4%. The negative effects of burnout require further study and intervention to determine the influence of burnout on the lives of clinical pharmacists and on other health care-related outcomes.

  13. Preventing device-associated infections in US hospitals: national surveys from 2005 to 2013.

    Science.gov (United States)

    Krein, Sarah L; Fowler, Karen E; Ratz, David; Meddings, Jennifer; Saint, Sanjay

    2015-06-01

    Numerous initiatives have focused on reducing device-associated infections, contributing to an overall decrease in infections nationwide. To better understand factors associated with this decline, we assessed the use of key practices to prevent device-associated infections by US acute care hospitals from 2005 to 2013. We mailed surveys to infection preventionists at a national random sample of ∼600 US acute care hospitals in 2005, 2009 and 2013. Our survey asked about the use of practices to prevent the 3 most common device-associated infections: central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI). Using sample weights, we estimated the per cent of hospitals reporting regular use (a score of 4 or 5 on a scale from 1 (never use) to 5 (always use)) of prevention practices from 2005 to 2013. The response rate was about 70% in all 3 periods. Use of most recommended prevention practices increased significantly over time. Among those showing the greatest increase were use of an antimicrobial dressing for preventing CLABSI (25-78%, ppreventing VAP (41-79%, ppreventing CAUTI (9-53%, pinfections. Practices for which little change was observed included use of antimicrobial catheters to prevent either CLABSI or CAUTI. US hospitals have responded to the call to reduce infection by increasing use of key recommended practices. Vigilance is needed to ensure sustained improvement and additional strategies may still be required, given an apparent continuing lag in CAUTI prevention efforts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Marketing research activities in hospitals. Satisfaction surveys of inpatients and outpatients are the most widely used application.

    Science.gov (United States)

    Loubeau, P R; Jantzen, R

    1998-01-01

    Virtually unheard of in health care 30 years ago, marketing research by hospitals is expanding at a notable rate, particularly among larger institutions located in highly competitive urban markets. Research applications are particularly pronounced at for-profit institutions, those heavily involved in managed care programs, and hospitals that are part of an integrated delivery system. However, the majority of hospital administrators surveyed indicated they do not invest in marketing research to track the effectiveness of their own institution's advertising.

  15. The accuracy of surface-contamination measurements; survey of UK hospitals, 1986

    International Nuclear Information System (INIS)

    Woods, M.J.

    1987-01-01

    In response to a number of concerns expressed at both national and international levels, the National Physical Laboratory (NPL) conducted a survey of UK hospitals and associated Regional Radiation Protection Services. Sources of surface contamination were distributed and participants were requested to measure these and interpret the relevant responses in terms of emission and activity per unit area. The analysis of the returns demonstrates that the vast majority of results was significantly in error and that the quality of radiation protection may be impaired. (author)

  16. Process-based organization design and hospital efficiency.

    Science.gov (United States)

    Vera, Antonio; Kuntz, Ludwig

    2007-01-01

    The central idea of process-based organization design is that organizing a firm around core business processes leads to cost reductions and quality improvements. We investigated theoretically and empirically whether the implementation of a process-based organization design is advisable in hospitals. The data came from a database compiled by the Statistical Office of the German federal state of Rheinland-Pfalz and from a written questionnaire, which was sent to the chief executive officers (CEOs) of all 92 hospitals in this federal state. We used data envelopment analysis (DEA) to measure hospital efficiency, and factor analysis and regression analysis to test our hypothesis. Our principal finding is that a high degree of process-based organization has a moderate but significant positive effect on the efficiency of hospitals. The main implication is that hospitals should implement a process-based organization to improve their efficiency. However, to actually achieve positive effects on efficiency, it is of paramount importance to observe some implementation rules, in particular to mobilize physician participation and to create an adequate organizational culture.

  17. [Hospital organizational analysis based on the Mintzberg model: the case of Sheikh Zayed Hospital, Rabat].

    Science.gov (United States)

    Makhloufi, Imane; Saadi, Janad; El Hiki, Lahcen; El Hassani, Amine

    2012-01-01

    The new system of hospital governance requires health institutions to develop new managerial, financial and social skills beyond their public service duties. As part of this new approach, the organizational modernization of hospitals involves introducing good management practices. However, managing the transition requires taking into account the specificities of existing organizational systems. Organizational systems are generally difficult to model and involve diverse and sometimes competing interests, concerns, habits, languages, cultures, tools and representations. This explains the high failure rate observed in hospital development projects at an organizational level. A number of organizational theories from a range of disciplines (sociology, biology, history, etc.) have examined the question of organization in hospitals. The many theories developed in this area are not incompatible. Rather, they form a set of useful tools for the analysis of organizational management. The purpose of this study was to conduct an organizational analysis of Sheikh Zayed Hospital (Rabat) based on the Mintzberg model as a prerequisite for the development and implementation of a restructuring plan.

  18. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  19. HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT FOR THE ADOPTION OF INNOVATIVE MEDICAL DEVICES WITHIN FRENCH HOSPITALS: OPPORTUNITIES AND CHALLENGES FOR INDUSTRY.

    Science.gov (United States)

    Dutot, Camille; Mercier, Grégoire; Borget, Isabelle; de Sauvebeuf, Côme; Martelli, Nicolas

    2017-01-01

    Within French university hospitals, some internal committees are in charge of conducting hospital-based health technology assessment (Hb-HTA) to support managerial decisions regarding the adoption of innovations. For manufacturers, hospitals are usually the entry point for new and innovative medical devices, which cannot be accessed without the Hb-HTA committees' approval. Thus, the main objective of this pilot survey was to explore manufacturers' insights into Hb-HTA processes. A two-step pilot survey was conducted in 2014. First, semi-structured phone interviews were carried out to capture manufacturers' feedback on the Hb-HTA procedure. Second, a prospective and iterative questionnaire designed to explore manufacturers' market access strategies was administered. Eight manufacturers from the medical device industry completed the retrospective phone interviews, and five of them participated in the prospective survey. According to the overall feedback, the Hb-HTA process timeline and transparency are major issues, and the expectations of internal committees, especially in terms of clinical evidence, remain difficult to understand. However, despite this and due to the complexity of reimbursement processes at the national level, manufacturers are increasingly considering hospital adoption through Hb-HTA submission as a viable market access and coverage opportunity. Our study reaffirms the primary role of hospitals in the diffusion of innovative medical devices. However, to ensure efficient and broad access to innovation, cooperation between local and national HTA bodies is critical and should be promoted.

  20. Demand for CAM Practice at Hospitals in Japan: A Population Survey in Mie Prefecture

    Directory of Open Access Journals (Sweden)

    Toshihiro Togo

    2011-01-01

    Full Text Available Complementary and alternative medicine (CAM therapies have been provided at hospitals along with conventional medicine in industrialized nations. Previous studies conducted in Japan revealed high proportion of Japanese had experience of using CAM, but failed to discuss how it should be provided. The present study aims to clarify the demand for CAM practice at hospitals in Japan. A questionnaire consisting of 41 questions was mailed to 10 000 adults randomly selected from the electoral roll of Mie prefecture, Japan in January 2007. The questionnaire asked the subjects about demand for CAM practice at hospitals, types of CAM therapy to be provided and associated reasons. Sociodemographic characteristics, perceived health status, experience and purpose of CAM use, and information resource for CAM were also surveyed. Completed answers were collected from 2824 (28.6% respondents. Two thousand and nineteen (71.5% of the respondents demanded CAM practice at hospitals with the most likely reason of “patients can receive treatment under the guidance of a physicians”. The three most popular CAM therapies were Kampo, acupressure/massage/Shiatsu and acupuncture/moxibustion. The demand was positively associated with gender, ages of 40–59 years, annual household incomes of 5–7 million yen, occupation of specialist and technical workers and sales workers and poor health status. Higher demand was observed among those who used both CAM and conventional medical therapies for curative purposes. In conclusion, Japanese show a high demand for CAM practice, hoping to use CAM for curative purposes with monitoring by physicians at hospitals.

  1. Patient blood management knowledge and practice among clinicians from seven European university hospitals: a multicentre survey.

    Science.gov (United States)

    Manzini, P M; Dall'Omo, A M; D'Antico, S; Valfrè, A; Pendry, K; Wikman, A; Fischer, D; Borg-Aquilina, D; Laspina, S; van Pampus, E C M; van Kraaij, M; Bruun, M T; Georgsen, J; Grant-Casey, J; Babra, P S; Murphy, M F; Folléa, G; Aranko, K

    2018-01-01

    The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. A web-based questionnaire was sent to 4952 clinicians working in medical, surgery and anaesthesiology disciplines. The responses were analysed, and the overall results as well as a comparison between hospitals are presented. A total of 788 responses (16%) were obtained. About 24% of respondents were not aware of a correlation between preoperative anaemia (POA) and perioperative morbidity and mortality. For 22%, treatment of POA was unlikely to favourably influence morbidity and mortality even before surgery with expected blood loss. More than half of clinicians did not routinely treat POA. 29%, when asked which is the best way to treat deficiency anaemia preoperatively, answered that they did not have sufficient knowledge and 5% chose to 'do nothing'. Amongst those who treated POA, 38% proposed red cell transfusion prior to surgery as treatment. Restrictive haemoglobin triggers for red blood cell transfusion, single unit policy and reduction of number and volumes of blood samples for diagnostic purposes were only marginally implemented. Overall, the responses indicated poor knowledge about PBM. Processes to diagnose and treat POA were not generally and homogeneously implemented. This survey should provide further impetus to implement programmes to improve knowledge and practice of PBM. © 2017 International Society of Blood Transfusion.

  2. A survey of the health needs of hospital staff: implications for health care managers.

    Science.gov (United States)

    Jinks, Annette M; Lawson, Valerie; Daniels, Ruth

    2003-09-01

    Developing strategies to address the health needs of the National Health Services (NHS) workforce are of concern to many health care managers. Focal to the development of such strategies are of being in receipt of baseline information about employees expressed health needs and concerns. This article addresses obtaining such baseline information and presents the findings of a health needs survey of acute hospital staff in a trust in North Wales. The total population of trust employees were surveyed (n = 2300) and a 44% (n = 1021) response rate was achieved. A number of positive findings are given. Included are that the majority of those surveyed stated that their current health status is good, are motivated to improve their health further, do not smoke and their alcohol consumption is within recommended levels. There appears, however, to be a number of areas where trust managers can help its staff improve their health. Included are trust initiatives that focus on weight control and taking more exercise. In addition, there appears to be a reported lack of knowledge and positive health behaviour amongst the male respondents surveyed that would imply the trust needs to be more effective in promoting well man type issues. Finally there appears to be a general lack of pride in working for the trust and a pervasive feeling that the trust does not care about its employees that needs to be addressed. It is concluded that the findings of this survey have implications for management practices in the trust where the survey was conducted and also wider applicability to the management of health care professionals. For example, addressing work-related psychological and physical problems of employees are of importance to all health care managers. This is especially so when considering recruitment and retention issues.

  3. A national survey of clinical pharmacy services in county hospitals in China.

    Science.gov (United States)

    Yao, Dongning; Xi, Xiaoyu; Huang, Yuankai; Hu, Hao; Hu, Yuanjia; Wang, Yitao; Yao, Wenbing

    2017-01-01

    Clinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system. The aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China. Public county hospitals in China. A national survey of clinical pharmacists in county hospitals was conducted. It was sampled through a stratified sampling strategy. Responses were analyzed using descriptive and inferential statistics. The main outcome measures include the coverage of clinical pharmacy services, the overall staffing of clinical pharmacists, the software and hardware of clinical pharmacy services, the charge mode of clinical pharmacy services, and the educational background, professional training acquisition, practical experience, and entry path of clinical pharmacists. The overall coverage of clinical pharmacy services on both the department scale (median = 18.25%) and the patient scale (median = 15.38%) does not meet the 100% coverage that is required by the government. In 57.73% of the sample hospitals, the staffing does not meet the requirement, and the size of the clinical pharmacist group is smaller in larger hospitals. In addition, 23.4% of the sample hospitals do not have management rules for the clinical pharmacists, and 43.1% do not have rational drug use software, both of which are required by the government. In terms of fees, 89.9% of the sample hospitals do not charge for the services. With regard to education, 8.5% of respondents are with unqualified degree, and among respondents with qualified degree, 37.31% are unqualified in the major; 43% of respondents lack the clinical pharmacist training required by the government. Most

  4. How do NHS general hospitals in England deal with patients with alcohol-related problems? A questionnaire survey.

    Science.gov (United States)

    Owens, Lynn; Gilmore, Ian T; Pirmohamed, Munir

    2005-01-01

    Alcohol-related disease represents a major burden on hospitals. However, it is unclear whether hospitals have developed the necessary expertise and guidelines to deal with this burden. The aim of this survey was to determine what measures general hospital NHS Trusts in England had in place to deal with alcohol-related problems, including the employment of dedicated alcohol specialist nurses. Two postal surveys of all NHS general hospital Trusts in England, the first in 2000 (n = 138; 54% response rate) and the second in 2003 after the publication of the Royal College of Physicians (RCP) report on alcohol in secondary care (n = 164; 75% response rate). Between the two surveys, there was a significant increase (P = 0.005) in the number of dedicated alcohol nurses employed by general hospital trusts; however, the numbers remain low (n = 21). Additionally, the availability of prescribing guidelines for the management of alcohol withdrawal increased significantly (P = 0.0001). The survey indicates that most general hospitals do not have appropriate services in place to deal with such patients. Although there is a need and willingness to develop alcohol services in general hospitals, which is one of the key recommendations of the RCP report, the lack of funding is going to act as a major barrier.

  5. Development and applicability of Hospital Survey on Patient Safety Culture (HSOPS) in Japan.

    Science.gov (United States)

    Ito, Shinya; Seto, Kanako; Kigawa, Mika; Fujita, Shigeru; Hasegawa, Toshihiko; Hasegawa, Tomonori

    2011-02-07

    Patient safety culture at healthcare organizations plays an important role in guaranteeing, improving and promoting overall patient safety. Although several conceptual frameworks have been proposed in the past, no standard measurement tool has yet been developed for Japan. In order to examine possibilities to introduce the Hospital Survey on Patient Safety Culture (HSOPS) in Japan, the authors of this study translated the HSOPS into Japanese, and evaluated its factor structure, internal consistency, and construct validity. Healthcare workers (n = 6,395) from 13 acute care general hospitals in Japan participated in this survey. Confirmatory factor analysis indicated that the Japanese HSOPS' 12-factor model was selected as the most pertinent, and showed a sufficiently high standard partial regression coefficient. The internal reliability of the subscale scores was 0.46-0.88. The construct validity of each safety culture sub-dimension was confirmed by polychoric correlation, and by an ordered probit analysis. The results of the present study indicate that the factor structures of the Japanese and the American HSOPS are almost identical, and that the Japanese HSOPS has acceptable levels of internal reliability and construct validity. This shows that the HSOPS can be introduced in Japan.

  6. A survey of role stress, coping and health in Australian and New Zealand hospital nurses.

    Science.gov (United States)

    Chang, Esther M L; Bidewell, John W; Huntington, Annette D; Daly, John; Johnson, Amanda; Wilson, Helen; Lambert, Vicki A; Lambert, Clinton E

    2007-11-01

    Previous research has identified international and cultural differences in nurses' workplace stress and coping responses. We hypothesised an association between problem-focused coping and improved health, emotion-focused coping with reduced health, and more frequent workplace stress with reduced health. Test the above hypotheses with Australian and New Zealand nurses, and compare Australian and New Zealand nurses' experience of workplace stress, coping and health status. Three hundred and twenty-eight New South Wales (NSW) and 190 New Zealand (NZ) volunteer acute care hospital nurses (response rate 41%) from randomly sampled nurses. Postal survey consisting of a demographic questionnaire, the Nursing Stress Scale, the WAYS of Coping Questionnaire and the SF-36 Health Survey Version 2. Consistent with hypotheses, more frequent workplace stress predicted lower physical and mental health. Problem-focused coping was associated with better mental health. Emotion-focused coping was associated with reduced mental health. Contrary to hypotheses, coping styles did not predict physical health. NSW and NZ scored effectively the same on sources of workplace stress, stress coping methods, and physical and mental health when controlling for relevant variables. Results suggest mental health benefits for nurses who use problem-solving to cope with stress by addressing the external source of the stress, rather than emotion-focused coping in which nurses try to control or manage their internal response to stress. Cultural similarities and similar hospital environments could account for equivalent findings for NSW and NZ.

  7. Job satisfaction and the work situation of physicians: a survey at a German university hospital.

    Science.gov (United States)

    Laubach, Wilfried; Fischbeck, Sabine

    2007-01-01

    Job demands and workload of hospital physicians are increasing. The object of this survey was to examine the factors that constitute job satisfaction and to analyse physicians' work situation in the area of in-patient care. 447 physicians at a German University Hospital received questionnaires with regard to work situation, job satisfaction and personal health. Data were analysed by MANOVA and multiple regression models. A first regression model explained 53% of the variance in satisfaction with "work and profession". Among the explanatory variables "superiors and hierarchy" showed the highest beta-weight (beta = -0.49). "Personal health" also determined job satisfaction, for female physicians stronger (beta = -0.31) than for male physicians (beta = -0.11). In a second regression model on satisfaction with "Financial situation" only 18% of the variance was explained, whereby "work condition on the ward", "personal health" and "collaboration between occupational groups" showed the highest beta-weights. Among resident physicians, work conditions, superiors, hierarchy, transparency and participation in decisions are very important variables for job satisfaction. Improvements in these aspects may improve job satisfaction and help to reduce physician shortage in hospitals.

  8. Leech management before application on patient: a nationwide survey of practices in French university hospitals

    Directory of Open Access Journals (Sweden)

    Delphine Grau

    2018-02-01

    Full Text Available Abstract Background Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%. We report the results of a national survey conducted in all the French university hospitals to assess the current extent of use of leech for medical practices in the hospital and to investigate maintenance, delivery practices and prevention of the risk of infection. Methods Data concerning conditions of storage, leech external decontamination, microbiological controls, mode of delivery and antibiotic prophylaxis were collected from all the French university hospitals in practicing leech therapy, on the basis of a standardized questionnaire. Results Twenty-eight of the 32 centers contacted filled the questionnaire, among which 23 practiced leech therapy, mostly with a centralized storage in the pharmacy; 39.1% of the centers declared to perform leech external decontamination and only 2 centers recurrent microbiological controls of the water storage. Leech delivery was mostly nominally performed (56.5%, but traceability of the leech batch number was achieved in only 39.1% of the cases. Only 5 centers declared that a protocol of antibiotic prophylaxis was systematically administered during leech therapy: either quinolone (2, sulfamethoxazole/trimethoprim (2 or amoxicillin/clavulanic acid (1. Conclusions Measures to prevent infectious complications before application to patient have to be better applied and guidelines of good practices are necessary.

  9. Hospital and clinic survey estimates of medical x-ray exposures in Hiroshima and Nagasaki, (1)

    International Nuclear Information System (INIS)

    Sawada, Shozo; Land, C.E.; Otake, Masanori; Russell, W.J.; Takeshita, Kenji.

    1980-11-01

    All large hospitals and 40% of the small hospitals and clinics in Hiroshima and Nagasaki cities were surveyed for the X-ray examinations they performed during a 2-week period in 1974. The frequency and type of X-ray examinations received by members of the RERF Adult Health Study (AHS) and the RERF Life Span Study (LSS) extended, excluding AHS (Non-AHS), were compared with the general population in each city. Radiologic exposures of patients at hospitals and clinics were most frequent among the general populations. The number of patients, examinations, and exposures per caput per year in each population were estimated. Since the age distribution differed among the three populations, comparisons were made only after correcting for age. On a per caput per year basis exposure frequency was relatively high in the AHS and low in the general populations, a reflection of the greater number of patients in the AHS than in the general populations. Non-AHS males in Nagasaki had a higher X-ray examination rate than did the AHS subjects. The others in the Non-AHS did not differ appreciably from the general populations. There was no difference among these groups according to body sites examined. (author)

  10. The Ideal Hospital Discharge Summary: A Survey of U.S. Physicians.

    Science.gov (United States)

    Sorita, Atsushi; Robelia, Paul M; Kattel, Sharma B; McCoy, Christopher P; Keller, Allan Scott; Almasri, Jehad; Murad, Mohammad Hassan; Newman, James S; Kashiwagi, Deanne T

    2017-09-06

    Hospital discharge summaries enable communication between inpatient and outpatient physicians. Despite existing guidelines for discharge summaries, they are frequently suboptimal. The aim of this study was to assess physicians' perspectives about discharge summaries and the differences between summaries' authors (hospitalists) and readers (primary care physicians [PCPs]). A national survey of 1600 U.S. physicians was undertaken. Primary measures included physicians' preferences in discharge summary standardization, content, format, and audience. A total of 815 physicians responded (response rate = 51%). Eighty-nine percent agreed that discharge summaries "should have a standardized format." Most agreed that summaries should "document everything that was done, found, and recommended in the hospital" (64%) yet "only include details that are highly pertinent to the hospitalization" (66%). Although 74% perceived patients as an important audience of discharge summaries, only 43% agreed that summaries "should be written in language that patients…can easily understand," and 68% agreed that it "should be written solely for provider-to-provider communication." Compared with hospitalists, PCPs preferred comprehensive summaries (68% versus 59%, P = 0.002). More PCPs agreed that separate summaries should be created for patients and for provider-to-provider communication than hospitalists (60% versus 47%, P summary" (44% versus 23%, P summary" (60% versus 38%, P summaries should have a standardized format but do not agree on how comprehensive or in what format they should be. Efforts are necessary to build consensus toward the ideal discharge summary.

  11. Survey of pediatric MDCT radiation dose from university hospitals in Thailand. A preliminary for national dose survey

    Energy Technology Data Exchange (ETDEWEB)

    Kritsaneepaiboon, Supika [Dept. of Radiology, Faculty of Medicine, Prince of Songkla Univ., Hat Yai (Thailand)], e-mail: supikak@yahoo.com; Trinavarat, Panruethai [Dept. of Radiology, Faculty of Medicine, Chulalongkorn Univ., Bangkok (Thailand); Visrutaratna, Pannee [Dept. of Radiology, Faculty of Medicine, Chiang Mai Univ., Chiang Mai (Thailand)

    2012-09-15

    Background: Increasing pediatric CT usage worldwide needs the optimization of CT protocol examination. Although there are previous published dose reference level (DRL) values, the local DRLs should be established to guide for clinical practice and monitor the CT radiation. Purpose: To determine the multidetector CT (MDCT) radiation dose in children in three university hospitals in Thailand in four age groups using the CT dose index (CTDI) and dose length product (DLP). Material and Methods: A retrospective review of CT dosimetry in pediatric patients (<15 years of age) who had undergone head, chest, and abdominal MDCT in three major university hospitals in Thailand was performed. Volume CTDI (CTDIvol) and DLP were recorded, categorized into four age groups: <1 year, 1- < 5 years, 5- <10 years, and 10- <15 years in each scanner. Range, mean, and third quartile values were compared with the national reference dose levels for CT in pediatric patients from the UK and Switzerland according to International Commission on Radiological Protection (ICRP) recommendation. Results: Per age group, the third quartile values for brain, chest, and abdominal CTs were, respectively, in terms of CTDIvol: 25, 30, 40, and 45 mGy; 4.5, 5.7, 10, and 15.6 mGy; 8.5, 9, 14, and 17 mGy; and in terms of DLP: 400, 570, 610, and 800 mGy cm; 80, 140, 305, and 470 mGy cm; and 190, 275, 560,765 mGy cm. Conclusion: This preliminary national dose survey for pediatric CT in Thailand found that the majority of CTDIvol and DLP values in brain, chest, and abdominal CTs were still below the diagnostic reference levels (DRLs) from the UK and Switzerland regarding to ICRP recommendation.

  12. Predictors of hospitalized patients' intentions to prevent healthcare harm: a cross sectional survey.

    Science.gov (United States)

    Davis, R; Anderson, O; Vincent, C; Miles, K; Sevdalis, N

    2012-04-01

    Patients can play an important role in reducing healthcare harm but little is known about the factors that may affect patients' willingness to participate. In order to encourage the 'active' patient it is critical that we gain a deeper understanding of the antecedents of safety-relevant behaviours. Doing this will enable the implementation of effective interventions aimed at supporting patients to work with healthcare professionals in ensuring safe care. To examine predictors of patients' intentions to engage in two safety behaviours: (1) reminding healthcare staff to wash their hands and; (2) notifying healthcare staff if they are not wearing a hospital identification bracelet. Cross-sectional survey study. A purposive sampling method was employed to recruit 80 medical and surgical hospital inpatients aged 18-80 (mean 48) from one inner city London teaching hospital. A 42 item survey that measured the extent that patients' control beliefs, behavioural beliefs, normative beliefs and perceived susceptibility and severity towards a hospital-acquired infection or a misidentification error could predict their intentions to ask doctors/nurses about their hand washing compliance or notify doctors/nurses if they are not wearing a hospital identification bracelet. Data was analysed using multiple regression analysis. Control beliefs, normative beliefs and perceived severity were the strongest predictors of patients' intentions to participate in both behaviours. The regression models accounted for a smaller percentage of the variance in patients' intentions to ask doctors/nurses if they have washed their hands (42%/37%) than notifying staff if they were not wearing an identification bracelet (54%/56%). If patients understand why a behaviour is beneficial, they perceive it as acceptable to participate in and that they have control over the decision to engage in the behaviour, we hypothesise that more patients will intend to participate in that behaviour. When designing

  13. A microprocessor based mobile radiation survey system

    International Nuclear Information System (INIS)

    Gilbert, R.W.; McCormack, W.D.

    1984-01-01

    A microprocessor-based system has been designed and constructed to enhance the performance of routine radiation surveys on roads within the Hanford site. This device continually monitors system performance and output from four sodium iodide detectors mounted on the rear bumper of a 4-wheel drive truck. The gamma radiation count rate in counts-per-second is monitored, and a running average computed, with the results compared to predefined limits. If an abnormal instantaneous or average count rate is detected, an alarm is sounded with responsible data displayed on a liquid crystal panel in the cab of the vehicle. The system also has the capability to evaluate detector output using multiple time constants and to perform more complex tests and comparison of the data. Data can be archived for later analysis on conventional chart recorders or stored in digital form on magnetic tape or other digital storage media

  14. Microprocessor based mobile radiation survey system

    International Nuclear Information System (INIS)

    Gilbert, R.W.; McCormack, W.D.

    1983-12-01

    A microprocessor-based system has been designed and constructed to enhance the performance of routine radiation surveys on roads within the Hanford site. This device continually monitors system performance and output from four sodium iodide detectors mounted on the rear bumper of a 4-wheel drive truck. The gamma radiation count rate in counts-per-second is monitored, and a running average computed, with the results compared to predefined limits. If an abnormal instantaneous or average count rate is detected, an alarm is sounded with responsible data displayed on a liquid crystal panel in the cab of the vehicle. The system also has the capability to evaluate detector output using multiple time constants and to perform more complex tests and comparison of the data. Data can be archived for later analysis on conventional chart recorders or stored in digital form on magnetic tape or other digital storage media. 4 figures

  15. Care quality following intrauterine death in Spanish hospitals: results from an online survey.

    Science.gov (United States)

    Cassidy, Paul Richard

    2018-01-10

    The objective of the study was to evaluate practices in Spanish hospitals after intrauterine death in terms of medical/ technical care and bereavement support care. A cross-sectional descriptive study using an online self-completion questionnaire. The population was defined as women who had experienced an intrauterine fetal death between sixteen weeks and birth, either through spontaneous late miscarriage/stillbirth or termination of pregnancy for medical reasons. Respondents were recruited through an online advertisement on a stillbirth charity website and social media. The analysis used Pearson's chi-squared (p ≤ 0.05) test of independence to cross-analyse for associations between objective measures of care quality and independent variables. Responses from 796 women were analysed. Half of the women (52.9%) had postmortem contact with their baby. 30.4% left the hospital with a least one linking object or a photograph. In 35.8% of cases parents weren't given any option to recover the body/remains. 22.9% of births ≥26 weeks gestation were by caesarean, with a significant (p < 0.001) difference between public hospitals (16.8%) and private hospitals (41.5%). 29.3% of respondents were not accompanied during the delivery. 48.0% of respondents recalled being administered sedatives at least once during the hospital stay. The autopsy rate in stillbirth cases (≥ 20 weeks) was 70.5% and 44.4% in cases of termination of pregnancy (all gestational ages). Consistent significant (p < 0.05) differences in care practices were found based on gestational age and type of hospital (public or private), but not to other variables related to socio-demographics, pregnancy history or details of the loss/death. Intrauterine deaths at earlier gestational ages received poorer quality care. Supportive healthcare following intrauterine death is important to women's experiences in the hospital and beneficial to the grief process. Many care practices that are standard in

  16. Activity-based computing for medical work in hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind

    2009-01-01

    principles, the Java-based implementation of the ABC Framework, and an experimental evaluation together with a group of hospital clinicians. The article contributes to the growing research on support for human activities, mobility, collaboration, and context-aware computing. The ABC Framework presents...

  17. Smoking habits in lung cancer patients: a hospital based case ...

    African Journals Online (AJOL)

    This retrospective, hospital based case-control study was designed to investigate the cigarette smoking history, the relationship between cigarette smoking and the risk of lung cancer in KHMC-Jordan. Six hundred cases with lung cancer (576 males, 24 females) and 600 controls were included in the study. The majority of ...

  18. Integrating knowledge based functionality in commercial hospital information systems.

    Science.gov (United States)

    Müller, M L; Ganslandt, T; Eich, H P; Lang, K; Ohmann, C; Prokosch, H U

    2000-01-01

    Successful integration of knowledge-based functions in the electronic patient record depends on direct and context-sensitive accessibility and availability to clinicians and must suit their workflow. In this paper we describe an exemplary integration of an existing standalone scoring system for acute abdominal pain into two different commercial hospital information systems using Java/Corba technolgy.

  19. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne

    2011-01-01

    Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...

  20. Effects of scanning and eliminating paper-based medical records on hospital physicians' clinical work practice.

    Science.gov (United States)

    Laerum, Hallvard; Karlsen, Tom H; Faxvaag, Arild

    2003-01-01

    It is not automatically given that the paper-based medical record can be eliminated after the introduction of an electronic medical record (EMR) in a hospital. Many keep and update the paper-based counterpart, and this limits the use of the EMR system. The authors have evaluated the physicians' clinical work practices and attitudes toward a system in a hospital that has eliminated the paper-based counterpart using scanning technology. Combined open-ended interviews (8 physicians) and cross-sectional survey (70 physicians) were conducted and compared with reference data from a previous national survey (69 physicians from six hospitals). The hospitals in the reference group were using the same EMR system without the scanning module. The questionnaire (English translation available as an online data supplement at ) covered frequency of use of the EMR system for 19 defined tasks, ease of performing them, and user satisfaction. The interviews were open-ended. The physicians routinely used the system for nine of 11 tasks regarding retrieval of patient data, which the majority of the physicians found more easily performed than before. However, 22% to 25% of the physicians found retrieval of patient data more difficult, particularly among internists (33%). Overall, the physicians were equally satisfied with the part of the system handling the regular electronic data as that of the physicians in the reference group. They were, however, much less satisfied with the use of scanned document images than that of regular electronic data, using the former less frequently than the latter. Scanning and elimination of the paper-based medical record is feasible, but the scanned document images should be considered an intermediate stage toward fully electronic medical records. To our knowledge, this is the first assessment from a hospital in the process of completing such a scanning project.

  1. A Review and Survey of Neurosurgeon-Hospital Relationships: Evolution and Options.

    Science.gov (United States)

    Kim, Dong H; Duco, Bernard; Wolterman, Daniel; Stokes, Charles; Brace, Rod; Solomon, Robert A; Barbaro, Nicholas; Westmark, Richard; MacDougall, David; Bean, James; O'Leary, Joanna; Moayeri, Nicole; Dacey, Ralph G; Berger, Mitchel S; Harbaugh, Robert

    2017-04-01

    As healthcare delivery shifts from fee-for-service, episodic care to pay for performance and population health, both hospitals and physicians are looking for new forms of integration. A number of regulations and restrictions govern physician relationships with hospitals. In this paper, we review the legal basis for such relationships and the options available. We also survey neurosurgeons and hospital executives to gain their perspective on the current situation and likely future. Two series of structured interviews were conducted with 10 neurosurgeons who work in a range of situations in diverse markets, and with Memorial Hermann Healthcare System senior executive leadership. Their responses form the basis for the subsequent discussion. Neurosurgeons can be independent, join a confederation such as an Independent Physician Association or another type of "clinically integrated" network, or be employed by a hospital, medical school, or physician group. With varying levels of integration comes the strength of size, management expertise, negotiating leverage, economies of scale, and possibly financial advantages, but with impact on autonomy and independence. Constructive alignment can lead to a win-win situation for both the individual physician and the organization, but options vary widely due to heterogeneous local conditions. This paper reviews possible relationships, moving along a spectrum from no financial integration to full integration. Concepts such as physician leasing, professional service agreements, "clinical integration," and employment are presented. This paper offers a practical reference that might be useful to a new graduate, independent neurosurgeon considering integration, or employed physicians considering alternatives. Copyright © 2016 by the Congress of Neurological Surgeons.

  2. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey.

    Directory of Open Access Journals (Sweden)

    Kai Xing

    Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

  3. Practical guidelines for developing a smartphone-based survey instrument

    DEFF Research Database (Denmark)

    Ohme, Jakob; de Vreese, Claes Holger; Albæk, Erik

    The increasing relevance of mobile surveys makes it important to gather empirical evidence on designs of such surveys. This research note presents the results of a test study conducted to identify the best set-up for a smartphone-based survey. We base our analysis on a random sample of Danish...

  4. Managerial competencies of hospital managers in South Africa: a survey of managers in the public and private sectors

    Directory of Open Access Journals (Sweden)

    Pillay Rubin

    2008-02-01

    Full Text Available Abstract Background South Africa has large public and private sectors and there is a common perception that public sector hospitals are inefficient and ineffective while the privately owned and managed hospitals provide superior care and are more sustainable. The underlying assumption is that there is a potential gap in management capacity between the two sectors. This study aims to ascertain the skills and competency levels of hospital managers in South Africa and to determine whether there are any significant differences in competency levels between managers in the different sectors. Methods A survey using a self administered questionnaire was conducted among hospital managers in South Africa. Respondents were asked to rate their proficiency with seven key functions that they perform. These included delivery of health care, planning, organizing, leading, controlling, legal and ethical, and self-management. Ratings were based on a five point Likert scale ranging from very low skill level to very high skill level. Results The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. Conclusion The findings confirm our supposition that there is a lack of management capacity within the public sector in South Africa and that there is a significant gap between private and public sectors. It provides evidence that there is a great need for further development of managers, especially those in the public sector. The onus is therefore on administrators and those responsible for management education and training to identify managers in need of development and to make available training that is contextually relevant in terms of design and delivery.

  5. Cerebral Palsy in Pakistani Children: A Hospital Based Survey

    Directory of Open Access Journals (Sweden)

    Atif Ahmed Khan

    2014-08-01

    Conclusion:Spastic quadriplegia or spastic diplegia are the commonest presentations in Pakistani children diagnosed with CP. The frequent etiological factors in CP development are birth asphyxia, prematurity, meningoencephalitis and kernicterus. [Cukurova Med J 2014; 39(4.000: 705-711

  6. Clostridium difficile infection in Europe: a hospital-based survey

    DEFF Research Database (Denmark)

    Bauer, Martijn P; Notermans, Daan W; van Benthem, Birgit H B

    2011-01-01

    Little is known about the extent of Clostridium difficile infection in Europe. Our aim was to obtain a more complete overview of C difficile infection in Europe and build capacity for diagnosis and surveillance.......Little is known about the extent of Clostridium difficile infection in Europe. Our aim was to obtain a more complete overview of C difficile infection in Europe and build capacity for diagnosis and surveillance....

  7. Microcomputer-based workforce scheduling for hospital porters.

    Science.gov (United States)

    Lin, C K

    1999-01-01

    This paper focuses on labour scheduling for hospital porters who are the major workforce providing routine cleansing of wards, transportation and messenger services. Generating an equitable monthly roster for porters while meeting the daily minimum demand is a tedious task scheduled manually by a supervisor. In considering a variety of constraints and goals, a manual schedule was usually produced in seven to ten days. To be in line with the strategic goal of scientific management of an acute care regional hospital in Hong Kong, a microcomputer-based algorithm was developed to schedule the monthly roster. The algorithm, coded in Digital Visual Fortran 5.0 Professional, could generate a monthly roster in seconds. Implementation has been carried out since September 1998 and the results proved to be useful to hospital administrators and porters. This paper discusses both the technical and human issues involved during the computerization process.

  8. An Expert System-Based Approach to Hospitality Company Diagnosis

    OpenAIRE

    Balfe, Andrew; O'Connor, Peter; McDonnell, Ciaran

    1994-01-01

    This paper describes the development of a prototype Expert System-based Analysis and Diagnostic (ESAD) package for the Hotel and Catering Industry. This computerised tool aids the hospitality manager in methodically scrutinising the hotel unit and environment, combining key information with systematic reasoning. The system searches through its extensive knowledge base, investigating complicated relationships. The number of possibilities considered is increased which will broaden the depth and...

  9. Is mobile teleconsulting equivalent to hospital-based telestroke services?

    Science.gov (United States)

    Audebert, Heinrich J; Boy, Sandra; Jankovits, Ralf; Pilz, Philipp; Klucken, Jochen; Fehm, Nando P; Schenkel, Johannes

    2008-12-01

    Telemedicine is increasingly used to provide acute stroke expertise for hospitals without full-time neurological services. Teleconsulting through mobile laptop computers may offer more flexibility compared with hospital-based services, but concerns about quality and technical reliability remain. We conducted a controlled trial, allocating hospital-based or mobile teleconsulting in a shift-by-shift sequence and evaluating technical parameters, acceptability, and impact on immediate clinical decisions. Both types of telemedicine workstations were equipped with DICOM (Digital-Imaging-and-Communications-in-Medicine) viewer and videoconference software. The laptop connected by asymmetrical broadband UMTS (Universal-Mobile-Telecommunication-Systems) technology with a one-way spoke-to-hub video transmission, whereas the hospital-based device used landline symmetrical telecommunication, including a 2-way videoconference. One hundred twenty-seven hospital-based and 96 mobile teleconsultations were conducted within 2 months without any technical breakdown. The rates per allocated time were similar with 3.8 and 4.0 per day. No significant differences were found for durations of videoconference (mean: 11+/-3 versus 10+/-3 minutes, P=0.07), DICOM download (3+/-3 versus 4+/-3 minutes, P=0.19), and total duration of teleconsultations (44+/-19 versus 45+/-21 minutes, P=0.98). Technical quality of mobile teleconsultations was rated worse on both sides, but this did not affect the ability to make remote clinical decisions like initiating thrombolysis (17% versus 13% of all, P=0.32). Teleconsultation using a laptop workstation and broadband mobile telecommunication was technically stable and allowed remote clinical decision-making. There remain disadvantages regarding videoconference quality on the hub side and lack of video transmission to the spoke side.

  10. Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals

    Directory of Open Access Journals (Sweden)

    Guest C

    2017-03-01

    Full Text Available Charlotte Guest,1 Fabian Sobotka,2 Athina Karavasopoulou,3 Stephen Ward,3 Carsten Bantel4,5 1Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; 2Division of Epidemiology and Biometry, Department of Health Services Research, Faculty 6, Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany; 3Pain Service, Barts Health, St Bartholomew’s Hospital, London, UK; 4Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Oldenburg University, Klinikum Oldenburg Campus, Oldenburg, Germany; 5Department of Surgery and Cancer, Anaesthetics Section, Imperial College London, Chelsea and Westminster Hospital Campus, London, UK Objective: Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses’ mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. Material and methods: A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses’ mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580 and one German (n=799 hospital between September 2014 and February 2015. Results: A total of 511 (37.1% questionnaires were returned. Mean (standard deviation age of participants were 37 (11 years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87

  11. Cost and utilisation of hospital based delivery care in Empowered Action Group (EAG) states of India.

    Science.gov (United States)

    Mohanty, Sanjay K; Srivastava, Akanksha

    2013-10-01

    Large scale investment in the National Rural Health Mission is expected to increase the utilization and reduce the cost of maternal care in public health centres in India. The objective of this paper is to examine recent trends in the utilization and cost of hospital based delivery care in the Empowered Action Group (EAG) states of India. The unit data from the District Level Household Survey 3, 2007-2008 is used in the analyses. The coverage and the cost of hospital based delivery at constant price is analyzed for five consecutive years preceding the survey. Descriptive and multivariate analyses are used to understand the socio-economic differentials in cost and utilization of delivery care. During 2004-2008, the utilization of delivery care from public health centres has increased in all the eight EAG states. Adjusting for inflation, the household cost of delivery care has declined for the poor, less educated and in public health centres in the EAG states. The cost of delivery care in private health centres has not shown any significant changes across the states. Results of the multivariate analyses suggest that time, state, place of residence, economic status; educational attainment and delivery characteristics of mother are significant predictors of hospital based delivery care in India. The study demonstrates the utility of public spending on health care and provides a thrust to the ongoing debate on universal health coverage in India.

  12. Assessing the adequacy of pressure ulcer prevention in hospitals: a nationwide prevalence survey.

    Science.gov (United States)

    Vanderwee, Katrien; Defloor, Tom; Beeckman, Dimitri; Demarré, Liesbet; Verhaeghe, Sofie; Van Durme, Thérèse; Gobert, Micheline

    2011-03-01

    The development of a pressure ulcer is an adverse event and is often avoidable if adequate preventive measures are applied. No large-scale data, based on direct patient observations, are available regarding the pressure ulcer preventive interventions used in hospitals. The aim of this study was to obtain insight into the adequacy of interventions used to prevent pressure ulcers in Belgian hospitals. A cross-sectional, multi-centre pressure ulcer prevalence study was performed in Belgian hospitals. The methodology used to measure pressure ulcer prevalence was developed by the European Pressure Ulcer Advisory Panel. The data collection instrument includes five categories of data: general data, patient data, risk assessment, skin observation and prevention. The total sample consisted of 19,968 patients. The overall prevalence of pressure ulcers Category I-IV was 12.1%. Only 10.8% of the patients at risk received fully adequate prevention in bed and while sitting. More than 70% of the patients not at risk received some pressure ulcer prevention while lying or sitting. Generally, there is a limited use of adequate preventive interventions for pressure ulcers in hospitals, which reflects a rather low quality of preventive care. The implementation of pressure ulcer guidelines requires more attention. The pressure ulcer prevention used in practice should be re-evaluated on a regular basis.

  13. Evaluation of Viewpoints of Health Care Professionals on the Role of Ethics Committees and Hospitals in the Resolution of Clinical Ethical Dilemmas Based on Practice Environment.

    Science.gov (United States)

    Marcus, Brian S; Carlson, Jestin N; Hegde, Gajanan G; Shang, Jennifer; Venkat, Arvind

    2016-03-01

    We sought to evaluate whether health care professionals' viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals (one tertiary care academic medical center, three large community hospitals and two small community hospitals). The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals (108-tertiary care center, 92-large community hospitals, 40-small community hospitals) completed the survey (response rate: 63.6 %). Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location.

  14. Low-birth-weight babies among hospital deliveries in Nepal: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Koirala AK

    2015-06-01

    Full Text Available Arun K Koirala,1 Dharma N Bhatta2,3 1Administrative Department, Helping Hands Community Hospital, Chabahil, Kathmandu, 2Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 3Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Background: Birth weight is an important indicator of a population’s health and is associated with numerous interrelated factors in the infant, mother, and physical environment. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a liveborn infant among the women in Morang, Nepal.Methods: A cross-sectional survey was carried out from December 2010 to March 2011 among 255 mothers who gave birth during the study period at the Koshi Zonal Hospital, Nepal. Data were collected using a structured questionnaire with face-to-face interviews. Data were analyzed through logistic regression and presented with crude and adjusted odds ratios (AORs with 95% confidence intervals (CIs.Results: The study showed that the prevalence of low-birth-weight babies was 23.1% (95% CI: 17.9–28.1. The mean (standard deviation age of mothers was 23.23 (4.18 years. The proportion of low birth weight of previous baby was 3.9% (95% CI: 0.1–7.9, and 15.7% (95% CI: 11.5–20.5 of the respondents had preterm delivery. Nearly one-third (36.1%; 95% CI: 26.4–45.6 of the respondents had >2 years’ gap after the previous delivery. Nonformal employment (AOR: 2.14; 95% CI: 0.523–8.74, vegetarian diet (AOR: 1.47; 95% CI: 0.23–9.36, and no rest during pregnancy (AOR: 1.38; 95% CI: 0.41–4.39 were factors more likely to determine low birth weight. However, none of the variables showed a significant association between low birth weight and other dependent variables.Conclusion: Low birth weight is an important factor for perinatal morbidity and mortality and is a common problem in the developing world. The

  15. Hospital-based ocular emergencies: epidemiology, treatment, and visual outcomes.

    Science.gov (United States)

    Cheung, Cindy A; Rogers-Martel, Melanie; Golas, Liliya; Chepurny, Anna; Martel, James B; Martel, Joseph R

    2014-03-01

    Ocular trauma is recognized as the leading cause of unilateral blindness. However, few studies to date have focused on the clinical features of hospital-based ocular emergencies. Effectiveness of trauma centers in treating ocular emergencies was compared with treatment in traditional community hospital emergency departments. Demographics, causes, and nature of ocular emergencies, as well as visual outcome in community hospitals emergency departments and trauma centers, were also examined. Records of 1027 patients with ocular emergencies seen between July 2007 and November 2010 at 3 community hospitals emergency departments and 2 hospitals with level II trauma centers were retrospectively examined. Unpaired t test and Pearson χ(2) test were used to determine statistical significance. The incidence of patients requiring ophthalmic intervention was 77.2 per 100 000 in the community hospitals and 208.9 per 100 000 in the trauma centers. Rates of ocular emergencies were higher in middle-aged, white men. Orbital fractures were found in 86% of all orbital contusion cases in trauma centers, whereas 66.7% of patients with fall injuries and open globe diagnoses resulted in legal blindness. The middle-aged, white men are more vulnerable to ocular injuries caused mainly by motor vehicle accidents. The ability of trauma centers to provide comparable increases in vision outcomes, despite treating more severe ocular emergencies, demonstrates the effectiveness of trauma centers. Patients diagnosed as having orbital contusions or who have fall injuries deserve careful evaluation because they are more likely to have more severe sight-threatening injuries. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Triangulation-based 3D surveying borescope

    Science.gov (United States)

    Pulwer, S.; Steglich, P.; Villringer, C.; Bauer, J.; Burger, M.; Franz, M.; Grieshober, K.; Wirth, F.; Blondeau, J.; Rautenberg, J.; Mouti, S.; Schrader, S.

    2016-04-01

    In this work, a measurement concept based on triangulation was developed for borescopic 3D-surveying of surface defects. The integration of such measurement system into a borescope environment requires excellent space utilization. The triangulation angle, the projected pattern, the numerical apertures of the optical system, and the viewing angle were calculated using partial coherence imaging and geometric optical raytracing methods. Additionally, optical aberrations and defocus were considered by the integration of Zernike polynomial coefficients. The measurement system is able to measure objects with a size of 50 μm in all dimensions with an accuracy of +/- 5 μm. To manage the issue of a low depth of field while using an optical high resolution system, a wavelength dependent aperture was integrated. Thereby, we are able to control depth of field and resolution of the optical system and can use the borescope in measurement mode with high resolution and low depth of field or in inspection mode with low resolution and higher depth of field. First measurements of a demonstrator system are in good agreement with our simulations.

  17. A survey of nutritional status of children 0-12 months in specialist hospital Gombe, Nigeria

    Directory of Open Access Journals (Sweden)

    Mela Danjin

    2015-01-01

    Full Text Available Background: This study was a cross-sectional survey of children and their mothers in specialist Hospital Gombe, Nigeria. Objective: Anthropometric assessment of nutritional status of the children (0-12 months and a survey of mothers′ opinion on malnutrition. Population: Children and mothers attending immunization sessions in specialist hospital Gombe, Nigeria. Materials and Methods: Hundred children (0-12 months attending immunization sessions were purposefully sampled and measured using sensitive anthropometric tools and techniques, while on the other arm of the study structured interviews were administered on the children′s consenting mothers (100 who turned in for their wards′ immunization. Only 97 out of 100 data collected on the children were used. Anthropometric indices used were height-for-age, weight-for-height, weight-for-age, and mid-upper arm circumference. Results: The study revealed a higher prevalence of moderate stunting in male (46.9% than in female (33.3% children (P 11 exhibited both severe and moderate forms of underweight. Among infants 3-5 months, moderate wasting was found to be less prevalent (4.2%. And despite the fact that 90% of their mothers showed a positive attitude toward exclusive breastfeeding, only 44% of them breastfed their infants exclusively from birth to the 6 th month of life. Conclusion: In order to address the various forms of nutritional derangements detected among the children, mothers should be targeted for infant nutritional education and authorities should institute poverty alleviation measures so as to address underlying causes of malnutrition.

  18. Visitor restriction policies and practices in children's hospitals in North America: results of an Emerging Infections Network Survey.

    Science.gov (United States)

    Pong, Alice L; Beekmann, Susan E; Faltamo, Mekleet M; Polgreen, Philip M; Shane, Andi L

    2018-06-21

    To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities. An electronic survey to characterize VRPP in pediatric healthcare facilities. The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed. A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate. Of the 104 respondents (61%) familiar with their VRPP, 92 (88%) had VRPP in all inpatient units. The respondents reported age-based VRPP (74%) symptom-based VRPP (97%), and outbreak-specific VRPP (75%). Symptom-based VRPP were reported to be seasonal by 24% of respondents and to be implemented year-round according to 70% of respondents. According to the respondents, communication of VRPP to families occurred at admission (87%) and through signage in care areas (64%), while communication of VRPP to staff occurred by email (77%), by meetings (55%), and by signage in staff-only areas (49%). Respondents reported that enforcement of VRPP was the responsibility of nursing (80%), registration clerks (58%), unit clerks (53%), the infection prevention team (31%), or clinicians 16 (16%). They also reported that the effectiveness of VRPP was assessed through active surveillance of hospital acquired respiratory infections (62%), through active surveillance of healthcare worker exposures (28%) and through patient/family satisfaction assessments (29%). Visitor restriction policies and practices vary in scope, implementation, enforcement, and physician awareness in pediatric facilities. A prospective multisite evaluation of outcomes would facilitate the adoption of uniform guidance.

  19. Can hospital-based doctors change their working hours? Evidence from Australia.

    Science.gov (United States)

    Norman, R; Hall, J

    2014-07-01

    To explore factors predicting hospital-based doctors' desire to work less, and then their success in making that change. Consecutive waves of an Australian longitudinal survey of doctors (Medicine in Australia-Balancing Employment and Life). There were 6285 and 6337 hospital-based completers in the two waves, consisting of specialists, hospital-based non-specialists and specialist registrars. Forty-eight per cent stated a preference to reduce hours. Predictive characteristics were being female and working more than 40 h/week (both P less likely to state the preference. Factors associated with not wanting to reduce working hours were being in excellent health and being satisfied with work (both P working hours, only 32% successfully managed to do so in the subsequent year (defined by a reduction of at least 5 h/week). Predictors of successfully reducing hours were being older, female and working more than 40 h/week (all P hours and then their subsequent success in doing so. Designing policies that seek to reduce attrition may alleviate some of the ongoing pressures in the Australian hospital system. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  20. Determining Family Needs on an Oncology Hospital Unit Using Interview, Art, and Survey.

    Science.gov (United States)

    Catlin, Anita; Ford, Marilee; Maloney, Carrie

    2016-04-01

    A movement worldwide, and specifically new to our hospital, is the implementation of Patient- and Family-Centered Care. We were unsure, however, what the needs were of our patients' families. This triangulated study, on a 28-bed oncology unit, studied family members at the bedside. We asked family members what their needs were in a three-step process (open-ended interview, use of the Draw a Bridge art therapy technique, and the Family Inventory of Needs survey). Nineteen interviews revealed needs for physical comfort, emotional support, cultural sensitivity, recognition of help provided by family members and improved pain management. Art therapy revealed the stress of caregiving and helped to uncover unmet needs for interviewers to explore. The FIN identified that care at home after discharge was a major worry. Knowledge of family members' needs while a loved one is in the hospital allows for planning and provision of modalities to assist them in their caregiving. © The Author(s) 2015.

  1. Nonoffending Guardian Assessment of Hospital-Based Sexual Abuse/Assault Services for Children.

    Science.gov (United States)

    Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Smith, Tanya

    2016-01-01

    In circumstances in which child sexual abuse/assault is suspected, pediatric guidelines recommend referral to services such as multidisciplinary hospital-based violence treatment centers, for specialized medical treatment, forensic documentation, and counseling. As little is known about how such services are perceived, the objective of this case report was to measure the satisfaction of nonoffending guardians of child sexual abuse/assault victims who presented for care at Ontario's hospital-based sexual assault treatment centers. Of the 1,136 individuals who reported sexual abuse/assault and were enrolled in a province-wide service evaluation, 58 were 11 years old and younger. Thirty-three guardians completed a survey. Ratings of care were overwhelmingly positive, with 97% of respondents indicating that they would recommend these services. Nonetheless, it is important to evaluate these pediatric sexual assault services frequently to ensure ongoing optimal, family-centered care.

  2. A Survey of Job Satisfaction among Health Sector Staff of Tabriz Taleghani Educational Hospital

    Directory of Open Access Journals (Sweden)

    Leila Rastgar-Farajzadeh

    2016-03-01

    Full Text Available Background and Objectives : Job satisfaction is one of the most important variables in organizational behavior and the key variable in organizational researches and theories as well. The aim of present investigation was to determine the level of job satisfaction among health sector staff of Tabriz Taleghani Educational Hospital. Material and Methods : This cross-sectional study was performed in 2014. Health sector staffs of Taleghani Educational Hospital were studied through census method. Data collection tool was a questionnaire based on previous studies and consisted of 3 parts: demographic information (7 items, job satisfaction (21 questions and factors related to employee dissatisfaction (10 items. After collecting and entering data into IBM SPSS software, independent t tests, chi-square and ANOVA were applied. Results : The highest level of job satisfaction was in the field of relationship with colleagues and lowest level of job satisfaction was related to salary and benefits. The most common cause of employee dissatisfaction was pressure and stressful working environment and the least cause was the improper distribution of employees based on workload . Conclusion : According to the findings, the majority of job satisfaction among staff was at low and medium-level. Since job satisfaction is an important factor in the performance and quality of services provided by the hospital staff, it is recommended that managers and officials pay attention to defects and shortcomings and remove barriers.

  3. Drug and therapeutics committees in Danish hospitals: a survey of organization, activities and drug selection procedures

    DEFF Research Database (Denmark)

    Plet, H. T.; Hallas, J.; Nielsen, Gitte S.

    2013-01-01

    To implement rational pharmacotherapy in hospitals, it is important to develop, implement and evaluate hospital drug formularies (HDFs). A report from Denmark recommended standardizing activities of the drug and therapeutics committees (DTCs) in Denmark, but little is known about their current...... organization. The aim of the study was to describe the organization of DTCs in Denmark, how HDFs are developed and implemented, and to what extent policies that support the use of HDFs exist. A questionnaire was developed based on previous research and guidelines and contained 20 questions, which were divided...... of the meetings lasted between 1 and 2.5 hr. Eight (89%) DTCs developed HDFs, policies and guidelines (P&Gs) that supported the use of HDFs. Eight (89%) had established criteria for inclusion of drugs on the HDFs, and seven had developed criteria for generic substitution and therapeutic interchange. The number...

  4. Should International Classification of Diseases codes be used to survey hospital-acquired pneumonia?

    Science.gov (United States)

    Wolfensberger, A; Meier, A H; Kuster, S P; Mehra, T; Meier, M-T; Sax, H

    2018-05-01

    As surveillance of hospital-acquired pneumonia (HAP) is very resource intensive, alternatives for HAP surveillance are needed urgently. This study compared HAP rates according to routine discharge diagnostic codes of the International Classification of Diseases, 10 th Revision (ICD-10; ICD-HAP) with HAP rates according to the validated surveillance definitions of the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE; HELICS-HAP) by manual retrospective re-evaluation of patient records. The positive predictive value of ICD-HAP for HELICS-HAP was 0.35, and sensitivity was 0.59. Therefore, the currently available ICD-10-based routine discharge data do not allow reliable identification of patients with HAP. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. A survey-based benchmarking approach for health care using the Baldrige quality criteria.

    Science.gov (United States)

    Jennings, K; Westfall, F

    1994-09-01

    Since 1988, manufacturing and service industries have been using the Malcolm Baldrige National Quality Award to assess their management processes (for example, leadership, information, and analysis) against critical performance criteria. Recognizing that the typical Baldrige assessment is time intensive and dependent on intensive training, The Pacer Group, a consulting firm in Dayton, Ohio, developed a self-assessment tool based on the Baldrige criteria which provides a snapshot assessment of an organization's management practices. The survey was administered at 25 hospitals within a health care system. Hospitals were able to compare their scores with other hospitals in the system, as well as the scores of a Baldrige award winner. Results were also analyzed on a systemwide basis to identify strengths and weaknesses across the system. For all 25 hospitals, the following areas were identified as strengths: management of process quality, leadership, and customer focus and satisfaction. Weaknesses included lack of employee involvement in the quality planning process, poor design of quality systems, and lack of cross-departmental cooperation. One of the surveyed hospitals launched improvement initiatives in knowledge of improvement tools and methods and in a patient satisfaction focus. A team was formed to improve the human resource management system. Also, a new unit was designed using patient-centered care principles. A team re-evaluated every operation that affected patients on the unit. A survey modeled after the Baldrige Award criteria can be useful in benchmarking an organization's quality improvement practices.

  6. The Aalborg Survey / Part 2 - GPS Based Survey

    DEFF Research Database (Denmark)

    Harder, Henrik; Reiter, Ida Maria; Christensen, Cecilie Breinholm

    , the GPS based data are supplemented with an attractivity analysis among the 169 respondents. The resulting data are presented in maps in three scales that illustrate the respondents’ use of Aalborg’s urban spaces with regards to the respondent’s movements in time and space. By further coupling the GPS...... data with data on the single respondent’s gender, age, address, activities, mode of transport, use of money etc. it is possible to gain a more detailed knowledge of young people’s use of urban spaces in Aalborg....

  7. The economic burden of influenza-associated outpatient visits and hospitalizations in China: a retrospective survey.

    Science.gov (United States)

    Yang, Juan; Jit, Mark; Leung, Kathy S; Zheng, Ya-Ming; Feng, Lu-Zhao; Wang, Li-Ping; Lau, Eric H Y; Wu, Joseph T; Yu, Hong-Jie

    2015-10-06

    The seasonal influenza vaccine coverage rate in China is only 1.9 %. There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level, even though this kind of information is important for informing national-level immunization policy decision-making. A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective. Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013. Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients. The study enrolled 529 outpatients (median age: eight years; interquartile range [IQR]: five to 20 years) and 254 inpatients (median age: four years; IQR: two to seven years). Among the outpatients, 22.1 % (117/529) had underlying diseases and among the inpatients, 52.8 % (134/254) had underlying diseases. The average total costs related to influenza-associated outpatient visits and inpatient visits were US$ 155 (standard deviation, SD US$ 122) and US$ 1,511 (SD US$ 1,465), respectively. Direct medical costs accounted for 45 and 69 % of the total costs related to influenza-associated outpatient and inpatient visits, respectively. For influenza outpatients, the mean cost per episode in children aged below five years (US$ 196) was higher than that in other age groups (US$ 129-153). For influenza inpatients, the mean cost per episode in adults aged over 60 years (US$ 2,735) was much higher than that in those aged below 60 years (US$ 1,417-1,621). Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions (outpatients: US$ 186 vs. US$ 146; inpatients: US$ 1

  8. Animal-assisted interventions: A national survey of health and safety policies in hospitals, eldercare facilities, and therapy animal organizations.

    Science.gov (United States)

    Linder, Deborah E; Siebens, Hannah C; Mueller, Megan K; Gibbs, Debra M; Freeman, Lisa M

    2017-08-01

    Animal-assisted intervention (AAI) programs are increasing in popularity, but it is unknown to what extent therapy animal organizations that provide AAI and the hospitals and eldercare facilities they work with implement effective animal health and safety policies to ensure safety of both animals and humans. Our study objective was to survey hospitals, eldercare facilities, and therapy animal organizations on their AAI policies and procedures. A survey of United States hospitals, eldercare facilities, and therapy animal organizations was administered to assess existing health and safety policies related to AAI programs. Forty-five eldercare facilities, 45 hospitals, and 27 therapy animal organizations were surveyed. Health and safety policies varied widely and potentially compromised human and animal safety. For example, 70% of therapy animal organizations potentially put patients at risk by allowing therapy animals eating raw meat diets to visit facilities. In general, hospitals had stricter requirements than eldercare facilities. This information suggests that there are gaps between the policies of facilities and therapy animal organizations compared with recent guidelines for animal visitation in hospitals. Facilities with AAI programs need to review their policies to address recent AAI guidelines to ensure the safety of animals and humans involved. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Current status of in-hospital donation coordinators in Japan: nationwide survey.

    Science.gov (United States)

    Konaka, S; Shimizu, S; Iizawa, M; Ohkawara, H; Kato, O; Ashikari, J; Fukushima, N

    2013-05-01

    When the Japanese Organ Transplantation Act was issued, the Japanese Organ Transplantation Network (JOT) was established in 1997. JOT lists recipients, assesses and manages organ donors, and educates publics and headquarters for organ donations. JOT procurement transplant coordinators (PTC) play roles in obtaining consent from relatives for organ donation, donor evaluation and management, organ recovery management, organ transport, and care of donor families during and after donation. Every prefecture has at least one PTC who is mainly working in public education and hospital development. They also help the JOT PTC at the time of organ procurement. Most prefectures commission hospital staff in the procurement hospital to be an in-hospital PTC (In-Hp PTC), who make their hospital staff aware of organ donation and support organ procurement. Although the Act was revised in 2010 with brain-dead organ donation increased from 13 to 44 cases yearly, the number was still extremely smaller than other developed countries. In these circumstances, In-Hp PTC may play greater roles to increase donation and smooth procurement procedures Our primary aim was to describe the current status of In-Hp PTC in Japan. Between December 15, 2011, and January 31, 2012, we invited 1889 In-Hp PTC to complete a letter survey using a self-designed questionnaire. In all, 56 In-Hp PTC (40%) completed and returned it. The occupation of the respondents was nurse (66%), physician (18%), or other (16%). Although 52% of respondents belonged to the hospital, which was designated for brain-death organ donation by the government, only 46% had any experience with a cadaveric donor. Only 2% were full-time In-Hp PTC. They mainly played a role in preparing their own manual for organ procurement (57%), providing in-hospital lectures (44%) or their own simulation exercise (29%), as well as coordinating donation cases. Although 77% had attended seminar about organ donation provided by JOT or the prefecture PTC

  10. Assessment of surveys for the management of hospital clinical pharmacy services.

    Science.gov (United States)

    Čufar, Andreja; Mrhar, Aleš; Robnik-Šikonja, Marko

    2015-06-01

    Survey data sets are important sources of data, and their successful exploitation is of key importance for informed policy decision-making. We present how a survey analysis approach initially developed for customer satisfaction research in marketing can be adapted for an introduction of clinical pharmacy services into a hospital. We use a data mining analytical approach to extract relevant managerial consequences. We evaluate the importance of competences for users of a clinical pharmacy with the OrdEval algorithm and determine their nature according to the users' expectations. For this, we need substantially fewer questions than are required by the Kano approach. From 52 clinical pharmacy activities we were able to identify seven activities with a substantial negative impact (i.e., negative reinforcement) on the overall satisfaction of clinical pharmacy services, and two activities with a strong positive impact (upward reinforcement). Using analysis of individual feature values, we identified six performance, 10 excitement, and one basic clinical pharmacists' activity. We show how the OrdEval algorithm can exploit the information hidden in the ordering of class and attribute values, and their inherent correlation using a small sample of highly relevant respondents. The visualization of the outputs turns out highly useful in our clinical pharmacy research case study. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. A survey of infection control practices of consultant anaesthesiologists in teaching hospitals of pakistan

    International Nuclear Information System (INIS)

    Yaqub, K.M.; Tariq, M.; Janjua, S.; Masroor, R.

    2007-01-01

    To determine the infection control practices of Anaesthesiologist in the teaching hospitals of Pakistan. Cross-sectional survey. The survey was closed after allowing 6 months for return of the replies. A questionnaire was distributed to 170 consultant anaesthesiologist randomly selected from all over Pakistan. Out of these, 90 (53%) were returned and analyzed. To reduce self-report bias, the forms were filled anonymously. Thirty four percent of the respondents always used masks, and only 9% used gloves in their every day practice. Only 18% of respondents stated that they always washed their hands after every patient contact and 54% reported that they always used aseptic technique for placing an indwelling cannula. Most respondents had a good knowledge of universal precautions for prevention of occupational transmission of infection. Five percent of the anaesthetists reported frequently or always reusing syringes for more than one patient. The practice of reusing syringes was significantly greater when the same consultants were anaesthetizing patients in private clinics rather than in their primary institutions (p 5, in 58% of cases. Whereas most responding anaesthesiologist exhibit appropriate infection control behaviour, there are several potentially hazardous practices that continue unabated. (author)

  12. A prospective survey of air and surface fungal contamination in a medical mycology laboratory at a tertiary care university hospital.

    Science.gov (United States)

    Sautour, Marc; Dalle, Frédéric; Olivieri, Claire; L'ollivier, Coralie; Enderlin, Emilie; Salome, Elsa; Chovelon, Isabelle; Vagner, Odile; Sixt, Nathalie; Fricker-Pap, Véronique; Aho, Serge; Fontaneau, Olivier; Cachia, Claire; Bonnin, Alain

    2009-04-01

    Invasive filamentous fungi infections resulting from inhalation of mold conidia pose a major threat in immunocompromised patients. The diagnosis is based on direct smears, cultural symptoms, and culturing fungi. Airborne conidia present in the laboratory environment may cause contamination of cultures, resulting in false-positive diagnosis. Baseline values of fungal contamination in a clinical mycology laboratory have not been determined to date. A 1-year prospective survey of air and surface contamination was conducted in a clinical mycology laboratory during a period when large construction projects were being conducted in the hospital. Air was sampled with a portable air system impactor, and surfaces were sampled with contact Sabouraud agar plates. The collected data allowed the elaboration of Shewhart graphic charts. Mean fungal loads ranged from 2.27 to 4.36 colony forming units (cfu)/m(3) in air and from 0.61 to 1.69 cfu/plate on surfaces. Strict control procedures may limit the level of fungal contamination in a clinical mycology laboratory even in the context of large construction projects at the hospital site. Our data and the resulting Shewhart graphic charts provide baseline values to use when monitoring for inappropriate variations of the fungal contamination in a mycology laboratory as part of a quality assurance program. This is critical to the appropriate management of the fungal risk in hematology, cancer and transplantation patients.

  13. Surgical site infection prevention: a survey to identify the gap between evidence and practice in University of Toronto teaching hospitals.

    Science.gov (United States)

    Eskicioglu, Cagla; Gagliardi, Anna R; Fenech, Darlene S; Forbes, Shawn S; McKenzie, Marg; McLeod, Robin S; Nathens, Avery B

    2012-08-01

    A gap exists between the best evidence and practice with regards to surgical site infection (SSI) prevention. Awareness of evidence is the first step in knowledge translation. A web-based survey was distributed to 59 general surgeons and 68 residents at University of Toronto teaching hospitals. Five domains pertaining to SSI prevention with questions addressing knowledge of prevention strategies, efficacy of antibiotics, strategies for changing practice and barriers to implementation of SSI prevention strategies were investigated. Seventy-six individuals (60%) responded. More than 90% of respondents stated there was evidence for antibiotic prophylaxis and perioperative normothermia and reported use of these strategies. There was a discrepancy in the perceived evidence for and the self-reported use of perioperative hyperoxia, omission of hair removal and bowel preparation. Eighty-three percent of respondents felt that consulting published guidelines is important in making decisions regarding antibiotics. There was also a discrepancy between what respondents felt were important strategies to ensure timely administration of antibiotics and what strategies were in place. Checklists, standardized orders, protocols and formal surveillance programs were rated most highly by 75%-90% of respondents, but less than 50% stated that these strategies were in place at their institutions. Broad-reaching initiatives that increase surgeon and trainee awareness and implementation of multifaceted hospital strategies that engage residents and attending surgeons are needed to change practice.

  14. Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

    Science.gov (United States)

    Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

    2016-05-01

    Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. CNMI Boat-based Creel Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Commonwealth of the Northern Mariana Islands (CNMI) Creel surveys are operated by the Division of Fish and Wildlife (DFW) and are only on the island of Saipan....

  16. The mental health of nurses in acute teaching hospital settings: a cross-sectional survey.

    Science.gov (United States)

    Perry, Lin; Lamont, Scott; Brunero, Scott; Gallagher, Robyn; Duffield, Christine

    2015-01-01

    Nursing is an emotionally demanding profession and deficiencies in nurses' mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses' health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals. A cross sectional survey design was used. The Registered and Enrolled Nurse workforce, employed on any form of contract, at two teaching hospitals in Sydney Australia were invited to participate. The survey tool was compiled of validated tools and questions. Family and medical history and health risk-related characteristics, current psycho-active medications, smoking status, alcohol intake, eating disorders, self-perceived general health, mental health and vitality, demographic, social and occupational details were collected. A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n = 49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12 month. Nurses had better mental health if they had better general health, lived with a spouse/ partner rather than alone, had fewer symptoms, sleep problems or disordered eating behaviours, were not an informal carer and did not work nights. Nurses had greater vitality if they were male, had better general health, fewer sleep problems or symptoms generally and lived with a spouse/ partner rather than alone; less vitality if they were an informal carer or had disordered eating. Nurses and their managers should strive to create workplaces where working practices promote nurses' health

  17. Demand-driven care and hospital choice. Dutch health policy toward demand-driven care: results from a survey into hospital choice.

    Science.gov (United States)

    Lako, Christiaan J; Rosenau, Pauline

    2009-03-01

    In the Netherlands, current policy opinion emphasizes demand-driven health care. Central to this model is the view, advocated by some Dutch health policy makers, that patients should be encouraged to be aware of and make use of health quality and health outcomes information in making personal health care provider choices. The success of the new health care system in the Netherlands is premised on this being the case. After a literature review and description of the new Dutch health care system, the adequacy of this demand-driven health policy is tested. The data from a July 2005, self-administered questionnaire survey of 409 patients (response rate of 94%) as to how they choose a hospital are presented. Results indicate that most patients did not choose by actively employing available quality and outcome information. They were, rather, referred by their general practitioner. Hospital choice is highly related to the importance a patient attaches to his or her physician's opinion about a hospital. Some patients indicated that their hospital choice was affected by the reputation of the hospital, by the distance they lived from the hospital, etc. but physician's advice was, by far, the most important factor. Policy consequences are important; the assumptions underlying the demand-driven model of patient health provider choice are inadequate to explain the pattern of observed responses. An alternative, more adequate model is required, one that takes into account the patient's confidence in physician referral and advice.

  18. Consumer attitudes about health care acquired infections: a German survey on factors considered important in the choice of a hospital.

    Science.gov (United States)

    Vonberg, Ralf-Peter; Sander, Carsten; Gastmeier, Petra

    2008-01-01

    Most patients are free in their choice of hospital for nonemergency admissions. In a nationwide survey in 1000 German households, we interviewed randomly chosen persons (age 14 and older) by phone about what they consider important when choosing a hospital. A standardized questionnaire was used. Additionally, question order was randomized prior to each interview. Demographic data included age, gender, education, and previous admissions to hospitals. Categories that might influence the choice of hospital included "distance to hospital," "friendly staff," "staff-to-patient ratio," "cleanliness," "nosocomial infection rate," "own experiences," "friend's opinion," and "facility's reputation in public media." General cleanliness, low nosocomial infection rates, and friendly staff proved to be the most important issues in our study. In contrast, the reputation of the health care facility in the public media was much less important. It seems that kindness and basic hygiene measures, both quite inexpensive factors, are key issues for patients.

  19. Survey study: The antibacterial drugs used for treatment of the animals in the teaching veterinary hospital in Kirkuk province

    Directory of Open Access Journals (Sweden)

    Y.J. Mousa

    2017-06-01

    Full Text Available The aim of this survey is to collect data relating to antibacterial drugs used to treat different animals in the veterinary teaching hospital in the province of Kirkuk, which is taking place for the first time at the province level for the purpose of knowing the types of drugs most commonly used and the outcome whether these drugs used are optimal. Data were collected from the veterinary teaching hospital in Kirkuk province for 6 consecutive months and for the period between 1/7/2016 and until 1/1/2017 period included both the summer and autumn and winter seasons. The results show that the most commonly used drugs were Oxytetracycline, Oxytetracycline, Doxycycline-Colistin compound by 26, 57 and 36% in cattle, sheep-goats and Poultry, respectively. While the least commonly used drugs were Tylosin, Gentamicin and Gentamicin-Tylosin compound by 10, 5 and 4% in cattle, sheep-goats and poultry, respectively. Based on the results obtained from this survey, we recommend the use of Penicillin-Streptomycin compound because it has a synergistic effect against most of the resistant bacteria and not to increase usage of Oxytetracycline because of its side effects and lack of effectiveness in recent times due to the abundance of resistant germs. Also, using antibacterial drugs, we would like to note the need for optimal scientific use of these drugs and to give attention to the period in which it takes the medicine to withdraw from the animal body before milking animals or slaughtering it, so that the bacterial resistance does not develop against these drugs in the future.

  20. Influencing factors of dysmenorrhoea among hospital nurses: a questionnaire survey in Taiwan.

    Science.gov (United States)

    Chiu, Min-Hui; Hsieh, Hsiu-Fen; Yang, Yi-Hsin; Chen, Huei-Mein; Hsu, Su-Chen; Wang, Hsiu-Hung

    2017-12-19

    Nurses are at high risk of dysmenorrhoea while working with patients. The study objectives were to: (1) describe the demographic and menstruation characteristics of dysmenorrhoea, knowledge about dysmenorrhoea and menstrual attitudes towards menstruation among dysmenorrhoeal and non-dysmenorrhoeal hospital nurses; (2) identify significant differences between the groups; and (3) examine factors influencing dysmenorrhoea. This cross-sectional survey used a structured questionnaire, administered at two hospitals in southern Taiwan. Participants included hospital nurses at least 18 years of age who agreed to participate. All participants were recruited through random sampling. The questionnaire included demographic data, the Dysmenorrhoea Knowledge Scale and Menstrual Attitude Scale (MAS). A total of 420 nurses completed the questionnaire. Among them, 297 (70.7%) had experienced dysmenorrhoea in the past 6 months and 123 (29.3%) had not. Significant differences in age (P<0.001), marital status (P<0.001), childbearing status (P<0.001), age at menarche (P<0.05) and rotating three shift ratio (P<0.05) were identified between the dysmenorrhoea and non-dysmenorrhoea groups. Analysis of the MAS results revealed significant differences between the groups regarding consideration of menstruation as a debilitating (P<0.001) or bothersome event (P<0.05), anticipation and prediction of menstruation onset (P<0.01) and denial of any effects from menstruation (P<0.001). Results of the multiple logistic regression showed that predictive factors included age <40 years (4.46 vs 1.00), working three shift rotations (2.07 vs 1.00), marital status (2.59 vs 1.00), acknowledging menstruation as a debilitating event (2.72 vs 1.00) and denial of effects from menstruation (2.59 vs 1.00). These findings could help nursing managers to create a caring and friendly work environment for hospital nurses at risk of dysmenorrhoea. © Article author(s) (or their employer(s) unless otherwise stated in

  1. Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals.

    Science.gov (United States)

    Guest, Charlotte; Sobotka, Fabian; Karavasopoulou, Athina; Ward, Stephen; Bantel, Carsten

    2017-01-01

    Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses' mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses' mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580) and one German (n=799) hospital between September 2014 and February 2015. A total of 511 (37.1%) questionnaires were returned. Mean (standard deviation) age of participants were 37 (11) years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87% did not regard opioids as drugs to help patients die, and 72% did not view them as drugs of abuse. More English (41%) than German (28%) nurses were afraid of criminal investigations and were constantly aware of side effects (UK, 94%; Germany, 38%) when using opioids. Four latent variables were identified which likely influence nurses' mental models: "conscious decision-making"; "medication-related fears"; "practice-based observations"; and "risk assessment". They were predicted by strength of religious beliefs and indicators of informal learning such as experience but not by indicators of formal learning such as conference attendance. Nurses in both countries employ analytical and affective mental models when administering the opioids and seem to learn from experience

  2. Pediatric CT scan usage in Japan. Results of a hospital survey

    Energy Technology Data Exchange (ETDEWEB)

    Ghotbi, N; Morishita, Mariko; Norimatsu, Nana; Namba, Hiroyuki; Yamashita, Shunichi [Nagasaki Univ., Graduate School of Biomedical Sciences, Nagasaki, Nagasaki (Japan); Ohtsuru, Akira [Nagasaki Univ., Hospital, Takashi Nagai Memorial International Hibakusha Medical Center, Nagasaki, Nagaski (Japan); Ogawa, Yoji; Uetani, Masataka; Moriuchi, Hiroyuki [Nagasaki Univ., Hospital, Nagasaki, Nagasaki (Japan)

    2006-10-15

    The aim of this study was to examine the usage parameters of diagnostic computed tomography (CT) in children because of concerns of possible overuse in Japanese hospitals, including the ''technical'' CT exposure settings and the ''clinical'' grounds for CT requests. We examined the methodology at the radiology department to reduce radiation exposure to children and performed a retrospective study on pediatric CT requests during a 1-year period at Nagasaki University Hospital. The parameters of diagnostic CT usage for minor head trauma and acute appendicitis were studied in detail. CT radiation dose settings are adjusted for children based on guidelines issued by the Japan Radiological Society, with few limitations. CT requests were made for 62% of minor head trauma cases and 76% of cases clinically suspected to be acute appendicitis. These figures are considerably higher than those reported by studies in the United Kingdom, Canada, or the United States. No specific guidelines are advocated regarding CT usage for minor head trauma. The diagnosis of acute appendicitis in children is almost routinely referred for confirmation'' by CT. CT radiation risks to children at Japanese hospitals need to be considered more seriously. Physicians should be encouraged to follow diagnostic algorithms that help avoid unnecessary CT usage in children. (author)

  3. Pediatric CT scan usage in Japan. Results of a hospital survey

    International Nuclear Information System (INIS)

    Ghotbi, N.; Morishita, Mariko; Norimatsu, Nana; Namba, Hiroyuki; Yamashita, Shunichi; Ohtsuru, Akira; Ogawa, Yoji; Uetani, Masataka; Moriuchi, Hiroyuki

    2006-01-01

    The aim of this study was to examine the usage parameters of diagnostic computed tomography (CT) in children because of concerns of possible overuse in Japanese hospitals, including the ''technical'' CT exposure settings and the ''clinical'' grounds for CT requests. We examined the methodology at the radiology department to reduce radiation exposure to children and performed a retrospective study on pediatric CT requests during a 1-year period at Nagasaki University Hospital. The parameters of diagnostic CT usage for minor head trauma and acute appendicitis were studied in detail. CT radiation dose settings are adjusted for children based on guidelines issued by the Japan Radiological Society, with few limitations. CT requests were made for 62% of minor head trauma cases and 76% of cases clinically suspected to be acute appendicitis. These figures are considerably higher than those reported by studies in the United Kingdom, Canada, or the United States. No specific guidelines are advocated regarding CT usage for minor head trauma. The diagnosis of acute appendicitis in children is almost routinely referred for confirmation'' by CT. CT radiation risks to children at Japanese hospitals need to be considered more seriously. Physicians should be encouraged to follow diagnostic algorithms that help avoid unnecessary CT usage in children. (author)

  4. [Have Case Loads of Radical Surgery for Prostate Cancer Been Concentrated in Hospitals with Robotic Equipment ?--Analyses with Questionnaire Survey and Diagnostic Procedure Combination (DPC) Data].

    Science.gov (United States)

    Tsukamoto, Taiji; Tanaka, Shigeru

    2016-04-01

    We investigated whether installation of robot-assisted surgical equipment in hospitals resulted in concentration of the case loads of radical prostatectomy. We selected 11 areas with populations of around 1 million or more where there were one or more hospitals with robotic equipment and 4 or more without it. In addition, annual changes of case loads for prostatectomy over 4 years from 2010 to 2013 were clearly determined in these areas. The case loads were determined based on the results of a questionnaire survey for the hospitals with robots and on the Diagnostic Procedures Combination data provided by the Ministry of Health, Labor and Wealth for those without such equipment. The concentration of the case loads was principally defined as when hospitals with robots had more predominant proportion of cases than those without them in the comparison between case loads prior to instillation of robots (or in the initial year of the study) and those in the final years. The 11 selected areas included 44 hospitals with robots and 156 without them. Concentration of case loads was found in 5 areas. In 4 areas, installation of robots did not have a specific relation to the distribution pattern s of case loads in hospitals with or without the equipment. The remaining 2 areas tended to have a weak but not definite concentration of case loads. In the areas in which installation did not influence case loads the further analysis revealed that their case loads had already been concentrated in the initial year (2010) of the study. Although the current results were found in a single department of the hospital, robotic installation may result in concentration of prostatectomy case loads for such hospitals in some areas. The current results are intriguing when we consider the future roles of acute care hospitals and beds in our country where the number of aged patients having chronic diseases will increase. In conclusion, installation of robotic equipment may result in concentration

  5. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  6. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer

    2013-01-01

    BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety...... children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care. RESULTS: All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age......, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): -0.2-19.5) and worry (P = 0.04; 95% CI: -0.4-20.6) in the home-care group indicating better physical health and less worry for children...

  7. Patient safety in surgical environments: Cross-countries comparison of psychometric properties and results of the Norwegian version of the Hospital Survey on Patient Safety

    Directory of Open Access Journals (Sweden)

    Nortvedt Monica W

    2010-09-01

    Full Text Available Abstract Background How hospital health care personnel perceive safety climate has been assessed in several countries by using the Hospital Survey on Patient Safety (HSOPS. Few studies have examined safety climate factors in surgical departments per se. This study examined the psychometric properties of a Norwegian translation of the HSOPS and also compared safety climate factors from a surgical setting to hospitals in the United States, the Netherlands and Norway. Methods This survey included 575 surgical personnel in Haukeland University Hospital in Bergen, an 1100-bed tertiary hospital in western Norway: surgeons, operating theatre nurses, anaesthesiologists, nurse anaesthetists and ancillary personnel. Of these, 358 returned the HSOPS, resulting in a 62% response rate. We used factor analysis to examine the applicability of the HSOPS factor structure in operating theatre settings. We also performed psychometric analysis for internal consistency and construct validity. In addition, we compared the percent of average positive responds of the patient safety climate factors with results of the US HSOPS 2010 comparative data base report. Results The professions differed in their perception of patient safety climate, with anaesthesia personnel having the highest mean scores. Factor analysis using the original 12-factor model of the HSOPS resulted in low reliability scores (r = 0.6 for two factors: "adequate staffing" and "organizational learning and continuous improvement". For the remaining factors, reliability was ≥ 0.7. Reliability scores improved to r = 0.8 by combining the factors "organizational learning and continuous improvement" and "feedback and communication about error" into one six-item factor, supporting an 11-factor model. The inter-item correlations were found satisfactory. Conclusions The psychometric properties of the questionnaire need further investigations to be regarded as reliable in surgical environments. The operating

  8. From intermittent antibiotic point prevalence surveys to quality improvement: experience in Scottish hospitals

    Directory of Open Access Journals (Sweden)

    Malcolm William

    2013-01-01

    Full Text Available Abstract Background In 2008, the Scottish Antimicrobial Prescribing Group (SAPG was established to coordinate a national antimicrobial stewardship programme. In 2009 SAPG led participation in a European point prevalence survey (PPS of hospital antibiotic use. We describe how SAPG used this baseline PPS as the foundation for implementation of measures for improvement in antibiotic prescribing. Methods In 2009 data for the baseline PPS were collected in accordance with the European Surveillance of Antimicrobial Consumption [ESAC] protocol. This informed the development of two quality prescribing indicators: compliance with antibiotic policy in acute admission units and duration of surgical prophylaxis. From December 2009 clinicians collected these data on a monthly basis. The prescribing indicators were reviewed and further modified in March 2011. Data for the follow up PPS in September 2011 were collected as part of a national PPS of healthcare associated infection and antimicrobial use developed using ECDC protocols. Results In the baseline PPS data were collected in 22 (56% acute hospitals. The frequency of recording the reason for treatment in medical notes was similar in Scotland (75.9% and Europe (75.7%. Compliance with policy (81.0% was also similar to Europe (82.5% but duration of surgical prophylaxis Conclusions The baseline PPS identified priorities for quality improvement. SAPG has demonstrated that implementation of regularly reviewed national prescribing indicators, acceptable to clinicians, implemented through regular systematic measurement can drive improvement in quality of antibiotic use in key clinical areas. However, our data also show that the ESAC PPS method may underestimate the proportion of surgical prophylaxis with duration

  9. [Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of the Tuscany Region].

    Science.gov (United States)

    Bambi, Stefano; Becattini, Giovanni; Pronti, Fabio; Lumini, Enrico; Rasero, Laura

    2013-01-01

    Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of Tuscany Region. Introduction. Lateral hostilities (LHs) are a kind of workplace violence. They are defined as varieties of cruel, rude, antagonistic interactions between people at the same hierarchical level. Nurses are affected by LH from 5.7% to 65%, leading to reduced work motivation, psycho-physical disorders, and in some cases, drop out of the nursing profession. Objective. To quantify the LHs among nurses in the emergency departments (ED) and intensive care units (ICU) in 5 hospitals of Tuscany (Italy). To show the impact on the quality of their psycho-physical and professional lives. Method. Exploratory-descriptive study, through closed-ended questionnaire. Results. 360/444 nurses (81%); 294 (81.6%) were victims of LHs during the past 12 months. Gossiping, complaints shared with others without discussing with the concerned person, and sarcastic comments were the most reported LHs. LHs occur more in EDs than ICUs (respectively 90% and 77%; p=0.0038). No statistically significant differences were observed for gender, age, or years of experience. The 17.7% of nurses asked to be moved from the ward, and 6.9% left it; 6.9% respondents had thought to leave the nursing profession; 235 (65.2%) experienced at least one LHs related disorder during the last year. Most reported symptoms were low morale, anxiety, and sleep disturbances. Conclusions. The incidence of LH and related disorders is high in EDs and ICUs, determining a low professional and psycho-physical quality of life.

  10. A survey on evaluation function for contaminations and doses in the primary and the secondary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Yamada, Yuji; Akashi, Makoto; Shiraishi, Kunio; Suzuki, Toshikazu; Ishigure, Nobuhito; Endo, Akira; Sanada, Tetsuya; Nakayama, Kazushige; Shizuma, Kiyoshi; Takada, Chie; Momose, Takumaro; Hoshi, Masaharu; Yamaguchi, Takenori

    2009-01-01

    The questionnaire on evaluation function for contaminations and doses was sent to the primary and the secondary radiation emergency hospitals in Japan by the network council for physical dosimetry in National Institute of Radiological Sciences (NIRS) designated as the tertiary hospital. The recovery percentage from the 88 hospitals was 70%. It turned out that six primary hospitals in 37 hospitals did not have even the basic instruments on radiation measurement such as GM counter and personal dosimeter. 64% of the secondary hospitals have the whole body counter, but its operation frequency including exercise was considerably low. It is thought that the main cause originates in a chronic manpower shortage and the budget shortfall seen by all the primary and the secondary hospitals. And also peculiar difficulty of correspondence to the radiation emergency medical treatment and the few experience might promote the problem. Thus the anxiety of the site staff had been appeared to the result of the questionnaire survey in shape like the opinion and the demand, etc. It will be necessary to advance the enhancement of training and to make the manual for the contaminations and the doses evaluation in the hospitals. (author)

  11. A survey on pain assessment in patients with disorders of consciousness in Dutch hospitals and nursing homes

    NARCIS (Netherlands)

    Vink, Peter; Verweij, Lotte; van Erp, Willemijn Sabien; Lucas, Cees; Vermeulen, Hester

    2015-01-01

    The extent of variation in the use of behavioural pain observation tools, documentation and pain protocols in patients with acquired brain injury (ABI) and with disorders of consciousness (DOC) is unknown. A national survey was undertaken in Dutch hospitals with neurology and neurosurgery nursing

  12. Understanding Barriers to Optimal Cleaning and Disinfection in Hospitals: A Knowledge, Attitudes, and Practices Survey of Environmental Services Workers.

    Science.gov (United States)

    Bernstein, Daniel A; Salsgiver, Elizabeth; Simon, Matthew S; Greendyke, William; Eiras, Daniel P; Ito, Masahiro; Caruso, Dean A; Woodward, Timothy M; Perriel, Odette T; Saiman, Lisa; Furuya, E Yoko; Calfee, David P

    2016-12-01

    In this study, we used an online survey to assess knowledge, attitudes, and practices related to environmental cleaning and other infection prevention strategies among environmental services workers (ESWs) at 5 hospitals. Our findings suggest that ESWs could benefit from additional education and feedback as well as new strategies to address workflow challenges. Infect Control Hosp Epidemiol 2016;1492-1495.

  13. "Against the silence": Development and first results of a patient survey to assess experiences of safety-related events in hospital

    Directory of Open Access Journals (Sweden)

    Schwappach David LB

    2008-03-01

    Full Text Available Abstract Background Involvement of patients in the detection and prevention of safety related events and medical errors have been widely recommended. However, it has also been questioned whether patients at large are willing and able to identify safety-related events in their care. The aim of this study was to develop and pilot test a brief patient safety survey applicable to inpatient care in Swiss hospitals. Methods A survey instrument was developed in an iterative procedure. The instrument asks patients to report whether they have experienced specific undesirable events during their hospital stay. The preliminary version was developed together with experts and tested in focus groups with patients. The adapted survey instrument was pilot-tested in random samples of patients of two Swiss hospitals (n = 400. Responders to the survey that had reported experience of any incident were sampled for qualitative interviews (n = 18. Based on the interview, the researcher classified the reported incidents as confirmed or discarded. Results The survey was generally well accepted in the focus groups and interviews. In the quantitative pilot test, 125 patients returned the survey (response rate: 31%. The mean age of responders was 55 years (range 17–91, SD 18 years and 62.5% were female. The 125 participating patients reported 94 "definitive" and 34 "uncertain" events. 14% of the patients rated any of the experienced events as "serious". The definitive and uncertain events reported with highest frequency were phlebitis, missing hand hygiene, allergic drug reaction, unavailability of documents, and infection. 23% of patients reported some or serious concerns about their safety. The qualitative interviews indicate that both, the extent of patients' uncertainty in the classification of events and the likelihood of confirmation by the interviewer vary very much by type of incident. Unexpectedly, many patients reported problems and incidents related to food

  14. Quantifying culture gaps between physicians and managers in Dutch hospitals: a survey

    Directory of Open Access Journals (Sweden)

    Meerdink Nienke

    2010-04-01

    Full Text Available Abstract Background The demands in hospitals for safety and quality, combined with limitations in financing health care require effective cooperation between physicians and managers. The complex relationship between both groups has been described in literature. We aim to add a perspective to literature, by developing a questionnaire which provides an opportunity to quantitatively report and elaborate on the size and content of differences between physicians and managers. Insight gained from use of the questionnaire might enable us to reflect on these differences and could provide practical tools to improve cooperation between physicians and managers, with an aim to enhance hospital performance. Methods The CG-Questionnaire was developed by adjusting, pre-testing, and shortening Kralewski's questionnaire, and appeared suitable to measure culture gaps. It was shortened by exploratory factor analysis, using principal-axis factoring extraction with Varimax rotation. The CG-Questionnaire was sent to all physicians and managers within 37 Dutch general hospitals. ANOVA and paired sample T-tests were used to determine significant differences between perceptions of daily work practices based in both professional cultures; culture gaps. The size and content of culture gaps were determined with descriptive statistics. Results The total response (27% consisted of 929 physicians and 310 managers. The Cronbachs alpha's were 0.70 - 0.79. Statistical analyses showed many differences; culture gaps were found in the present situation; they were even larger in the preferred situation. Differences between both groups can be classified into three categories: (1 culture gaps in the present situation and not in the preferred, (2 culture gaps in the preferred situation and not in the present, and (3 culture gaps in both situations. Conclusions With data from the CG-Questionnaire it is now possible to measure the size and content of culture gaps between physicians and

  15. SNE's methodological basis - web-based software in entrepreneurial surveys

    DEFF Research Database (Denmark)

    Madsen, Henning

    This overhead based paper gives an introduction to the research methodology applied in the surveys carried out in the SNE-project.......This overhead based paper gives an introduction to the research methodology applied in the surveys carried out in the SNE-project....

  16. Survey of Employees' Safety Attitude in a Teaching Hospital Tehran 2010

    Directory of Open Access Journals (Sweden)

    M. Mahmmoudi

    2011-01-01

    Full Text Available Background and aimsThe Medical Errors and the potential unsafe actions are always regarded as a serious trouble by the managers and health care providers. Using the employees' attitude data as a measurement criterion in the evaluation of the hospitals performance in the field of the “Safety” can improve the safety level among the personnel and patients . Survey of employees' attitude about safety and its comparison with different groups of offering health services in a teaching Hospital was the main objective of present study.   MethodsIn order to specify patient safety culture in Moddares hospital, all employees including physicians, nurses, managers and employees of Para-clinic, a volume sample consisting of 212 persons were selected. Then it was used from questionnaire of safety attitude within 6 dimensions including Teamwork climate, Safety climate, perceptions of Management , Job Satisfaction, Working Conditions and Stress Recognition. At first this questionnaire was gone under assessing validity and trust. The scale of measuring, Likert was 5 grades. In order to specify difference between groups under study it was used from ANOVA test.   Results Positive safety culture within 6 dimensions including Teamwork Climate, Safety climate, Job Satisfaction, Stress Recognition, Perception of Management , Working Conditions for doctors were 3, 4.13, 17.4, 0, 4.3, and 8.7 respectively; the aforesaid Dimensions for nurses were 19, 2.6, 10.3, 7.8, 2.6 and 15.5 respectively, the aforesaid Dimensions for managers were 30.3, 6.1, 33.3, 0, 18.2 and 21.2 respectively and the aforesaid Dimensions for employees of Para-clinic Were 50, 12.5, 25, 12.5, 10 and 37.5 respectively. There was Significant difference from View Point of statistics (p<0.5 from Dimensions of Job satisfaction among managers and nurses, employees of Para-clinic and nurses this difference Were zero and 0.001. From View Point of Stress recognition among managers and employees of Para

  17. Australian Hospital-Based Nurse Educators' Perceptions of Their Role.

    Science.gov (United States)

    Thornton, Karleen

    2018-06-01

    This article presents the findings from a phenomenological study that explored the understandings of Australian hospital-based nurse educators' experiences of their role. Purposive sampling resulted in 11 nurse educators from four large metropolitan hospitals within an Australian jurisdiction. The participants were asked how they understand their role and translate that understanding into practice. Thematic analysis identified four themes representative of nurse educators' understanding of their role: Becoming an Educator, Capability Building, Panacea, and Tension. A coherent picture emerged from subthemes highlighting that nurse educators were undervalued and value is added. Being undervalued and value adding are translated into nurse educator practice as resilience, being educationally literate, investing, and having a presence. This article identifies a gap in knowledge related to understanding the nurse educator role and informs recruitment and subsequent retention of nurses into nurse educator roles at a time when the nursing workforce in Australia and internationally is about to experience a major shortfall. Findings are specific to the Australian context and are not necessarily generalizable to other hospital jurisdictions. J Contin Educ Nurs. 2018;49(6):274-281. Copyright 2018, SLACK Incorporated.

  18. Financial Performance of Hospitals in the Mississippi Delta Region Under the Hospital Readmissions Reduction Program and Hospital Value-based Purchasing Program.

    Science.gov (United States)

    Chen, Hsueh-Fen; Karim, Saleema; Wan, Fei; Nevola, Adrienne; Morris, Michael E; Bird, T Mac; Tilford, J Mick

    2017-11-01

    Previous studies showed that the Hospital Readmissions Reduction Program (HRRP) and the Hospital Value-based Purchasing Program (HVBP) disproportionately penalized hospitals caring for the poor. The Mississippi Delta Region (Delta Region) is among the most socioeconomically disadvantaged areas in the United States. The financial performance of hospitals in the Delta Region under both HRRP and HVBP remains unclear. To compare the differences in financial performance under both HRRP and HVBP between hospitals in the Delta Region (Delta hospitals) and others in the nation (non-Delta hospitals). We used a 7-year panel dataset and applied difference-in-difference models to examine operating and total margin between Delta and non-Delta hospitals in 3 time periods: preperiod (2008-2010); postperiod 1 (2011-2012); and postperiod 2 (2013-2014). The Delta hospitals had a 0.89% and 4.24% reduction in operating margin in postperiods 1 and 2, respectively, whereas the non-Delta hospitals had 1.13% and 1% increases in operating margin in postperiods 1 and 2, respectively. The disparity in total margins also widened as Delta hospitals had a 1.98% increase in postperiod 1, but a 0.30% reduction in postperiod 2, whereas non-Delta hospitals had 1.27% and 2.28% increases in postperiods 1 and 2, respectively. The gap in financial performance between Delta and non-Delta hospitals widened following the implementation of HRRP and HVBP. Policy makers should modify these 2 programs to ensure that resources are not moved from the communities that need them most.

  19. Key performance indicators in hospital based on balanced scorecard model

    Directory of Open Access Journals (Sweden)

    Hamed Rahimi

    2017-01-01

    Full Text Available Introduction: Performance measurement is receiving increasing verification all over the world. Nowadays in a lot of organizations, irrespective of their type or size, performance evaluation is the main concern and a key issue for top administrators. The purpose of this study is to organize suitable key performance indicators (KPIs for hospitals’ performance evaluation based on the balanced scorecard (BSC. Method: This is a mixed method study. In order to identify the hospital’s performance indicators (HPI, first related literature was reviewed and then the experts’ panel and Delphi method were used. In this study, two rounds were needed for the desired level of consensus. The experts rated the importance of the indicators, on a five-point Likert scale. In the consensus calculation, the consensus percentage was calculated by classifying the values 1-3 as not important (0 and 4-5 to (1 as important. Simple additive weighting technique was used to rank the indicators and select hospital’s KPIs. The data were analyzed by Excel 2010 software. Results: About 218 indicators were obtained from a review of selected literature. Through internal expert panel, 77 indicators were selected. Finally, 22 were selected for KPIs of hospitals. Ten indicators were selected in internal process perspective and 5, 4, and 3 indicators in finance, learning and growth, and customer, respectively. Conclusion: This model can be a useful tool for evaluating and comparing the performance of hospitals. However, this model is flexible and can be adjusted according to differences in the target hospitals. This study can be beneficial for hospital administrators and it can help them to change their perspective about performance evaluation.

  20. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  1. Welfare, wellness, and job satisfaction of Chinese physicians: A national survey of public tertiary hospitals in China.

    Science.gov (United States)

    Sun, Jing; Ma, Jing; Hu, Guangyu; Zhao, Qi; Yuan, Changzheng; Si, Wen; Zhang, Xinqing; Liu, Yuanli

    2017-07-01

    Little national data are available on Chinese physicians' welfare, wellness, and job satisfaction. We conducted a self-administered smartphone-based national survey in early 2016 of 17 945 physicians from 136 tertiary hospitals across 31 provinces in China. In addition to collecting the physicians' basic information, we also measured 5 domains (the ethical and working environments, welfare, wellness, and job satisfaction). Half of the physicians reported a hospital-based annual income of less than RMB 72 000 ($10 300), and 60.31% of them did not think that the current medical pricing system reflects physicians' value. More than half (58.64%) of them did not have or did not know about medical malpractice insurance. These physicians worked long hours (an average of 10 h) and slept short hours (average 6 h). Only 35.78% of them thought that they were in good health, and 51.03% were in good mental health. Approximately, a quarter of them had helped to pay medical bills for patients who could not afford care, and 1 in 7 has been penalised for seeing patients who generated bad debts. Only 33.42% of them thought that their occupation receives social recognition and respect, and 70.98% would not encourage their children to pursue a medical career. The top 3 factors that may influence physician job satisfaction as chosen by the physicians were as follows: (1) the income distribution policy (45.92%), (2) working environment safety (25.86%), and (3) public trust and respect for their job (16.10%). In conclusion, we found that Chinese physicians bear heavy physical, mental, and financial stress, and many of them lack confidence that they receive trust and respect from society. Copyright © 2017 John Wiley & Sons, Ltd.

  2. Validation of hospital register-based diagnosis of Parkinson's disease

    DEFF Research Database (Denmark)

    Wermuth, Lene; Lassen, Christina Funch; Himmerslev, Liselotte

    2012-01-01

    Denmark has a long-standing tradition of maintaining one of the world's largest health science specialized register data bases as the National Hospital Register (NHR). To estimate the prevalence and incidence of diseases, the correctness of the diagnoses recorded is critical. Parkinson's disease...... (PD) is a neurodegenerative disorder and only 75-80% of patients with parkinsonism will have idiopathic PD (iPD). It is necessary to follow patients in order to determine if some of them will develop other neurodegenerative diseases and a one-time-only diagnostic code for iPD reported in the register...

  3. A survey of machine readable data bases

    Science.gov (United States)

    Matlock, P.

    1981-01-01

    Forty-two of the machine readable data bases available to the technologist and researcher in the natural sciences and engineering are described and compared with the data bases and date base services offered by NASA.

  4. Survey on changes of breast cancer radiotherapy in four hospitals within southeast coastal region of China

    International Nuclear Information System (INIS)

    Ji Yongling; Liu Jingjie; Tian Ye; Li Xianming; Zhu Yaqun; Yu De; Du Xianghui

    2010-01-01

    Objective: to explore the changes and the tendency of breast cancer radiotherapy in China within the past decade. Methods: A survey on breast cancer radiotherapy in 1999 and 2006 was conducted in 4 hospitals located within the southeast coastal region of China, including patients' clinical characteristics, the purpose of radiotherapy and its techniques. Results: The percentage of breast conservative treatment (BCT) increased from 3% in 1999 to 13% in 2006. For radiotherapy techniques in 2066 compared with 1999, the growth trend was found in use of breast immobilization devices (80% vs. 46%), treatment planning system (70% vs. 23%), and CT simulation (14% vs. 0). The frequency was increased in the chest wall irradiation after mastectomy (90% vs. 67%), but decreased in internal mammary region (30% vs. 76%) and axilla (37% vs. 69%) treatment. There were no differences in total dose and fractionation prescription. Conclusions: BCT was performed more frequently, but post-mastectomy radiotherapy was still essential option in China at present. Although some advanced techniques were applied frequently in clinical practice. Simulation, treatment planning, and irradiation target design were urgent for improvement and standardization. (authors)

  5. A survey on distribution and toxigenicity of Aspergillus flavus from indoor and outdoor hospital environments.

    Science.gov (United States)

    Sepahvand, Asghar; Shams-Ghahfarokhi, Masoomeh; Allameh, Abdolamir; Jahanshiri, Zahra; Jamali, Mojdeh; Razzaghi-Abyaneh, Mehdi

    2011-11-01

    In the present study, genetic diversity and mycotoxin profiles of Aspergillus flavus isolated from air (indoors and outdoors), levels (surfaces), and soils of five hospitals in Southwest Iran were examined. From a total of 146 Aspergillus colonies, 63 isolates were finally identified as A. flavus by a combination of colony morphology, microscopic criteria, and mycotoxin profiles. No Aspergillus parasiticus was isolated from examined samples. Chromatographic analyses of A. flavus isolates cultured on yeast extract-sucrose broth by tip culture method showed that approximately 10% and 45% of the isolates were able to produce aflatoxin B(1) (AFB(1)) and cyclopiazonic acid (CPA), respectively. Around 40% of the isolates produced sclerotia on Czapek-Dox agar. The isolates were classified into four chemotypes based on the ability to produce AF and CPA that majority of them (55.5%) belonged to chemotype IV comprising non-mycotoxigenic isolates. Random amplified polymorphic DNA (RAPD) profiles generated by a combination of four selected primers were used to assess genetic relatedness of 16 selected toxigenic and non-toxigenic isolates. The resulting dendrogram demonstrated the formation of two separate clusters for the A. flavus comprised both mycotoxigenic and non-toxigenic isolates in a random distribution. The obtained results in this study showed that RAPD profiling is a promising and efficient tool to determine intra-specific genetic variation among A. flavus populations from hospital environments. A. flavus isolates, either toxigenic or non-toxigenic, should be considered as potential threats for hospitalized patients due to their obvious role in the etiology of nosocomial aspergillosis.

  6. [Anaesthesia education at german university hospitals: the teachers' perspective -- results of a nationwide survey].

    Science.gov (United States)

    Goldmann, K; Steinfeldt, T; Wulf, H

    2006-04-01

    The principle purpose of this study was to collect data on the conditions and practice of anaesthesia education as well as the teaching qualification of consultants at German university hospitals. Based upon the collected data, areas of weakness and strength as well as measures required to improve anaesthesia training are described. A questionnaire containing 26 items was mailed to 607 consultants employed at 41 German university hospitals in June 2003. A total of 255 questionnaires was analysed (response rate: 43 %). Genuine training activities account for 14 % of the working hours of the participating consultants. On average, at the institutions of participating consultants, novices work for a duration of 1 month together with a consultant anaesthetist before they give anaesthetics without direct and constant supervision. When asked to describe the predominant method of training at their institution 71 % indicated "case-oriented teaching"; however, 53 % chose "see one, do one, teach one" and 49 % "learning by doing" as method of training as well (multiple choice). According to 63 % of respondents, departmental educational activities usually happen after their regular working hours. "Daily workload" (96 %), "time pressure" (96 %), "lack of time" (96 %) and "lack of personnel" (90 %) were indicated as the main obstacles of teaching. According to 80 % of respondents, a dedicated financial budget for education does not exist; instead, financial resources of third parties (industry) (58 %), of the state (for research und undergraduate education) (60 %) and of patients service (66 %) are used to ensure training of anaesthesia residents. Due to a lack of a dedicated financial budget for resident training and an increasing economic pressure, "lack of time" and "lack of personnel" are the main factors leading to the situation at German university hospitals that consultants can only spend 14 % of their working hours for teaching purposes despite of sufficient qualification

  7. Moving Towards the Age-friendly Hospital: A Paradigm Shift for the Hospital-based Care of the Elderly.

    Science.gov (United States)

    Huang, Allen R; Larente, Nadine; Morais, Jose A

    2011-12-01

    Care of the older adult in the acute care hospital is becoming more challenging. Patients 65 years and older account for 35% of hospital discharges and 45% of hospital days. Up to one-third of the hospitalized frail elderly loses independent functioning in one or more activities of daily living as a result of the 'hostile environment' that is present in the acute hospitals. A critical deficit of health care workers with expertise and experience in the care of the elderly also jeopardizes successful care delivery in the acute hospital setting. We propose a paradigm shift in the culture and practice of event-driven acute hospital-based care of the elderly which we call the Age-friendly Hospital concept. Guiding principles include: a favourable physical environment; zero tolerance for ageism throughout the organization; an integrated process to develop comprehensive services using the geriatric approach; assistance with appropriateness decision-making and fostering links between the hospital and the community. Our current proposed strategy is to focus on delirium management as a hospital-wide condition that both requires and highlights the Geriatric Medicine specialist as an expert of content, for program development and of evaluation. The Age-friendly Hospital concept we propose may lead the way to enable hospitals in the fast-moving health care system to deliver high-quality care without jeopardizing risk-benefit, function, and quality of life balances for the frail elderly. Recruitment and retention of skilled health care professionals would benefit from this positive 'branding' of an institution. Convincing hospital management and managing change are significant challenges, especially with competing priorities in a fiscal environment with limited funding. The implementation of a hospital-wide delirium management program is an example of an intervention that embodies many of the principles in the Age-friendly Hospital concept. It is important to change the way

  8. Controlling nosocomial infection based on structure of hospital social networks.

    Science.gov (United States)

    Ueno, Taro; Masuda, Naoki

    2008-10-07

    Nosocomial infection (i.e. infection in healthcare facilities) raises a serious public health problem, as implied by the existence of pathogens characteristic to healthcare facilities such as methicillin-resistant Staphylococcus aureus and hospital-mediated outbreaks of influenza and severe acute respiratory syndrome. For general communities, epidemic modeling based on social networks is being recognized as a useful tool. However, disease propagation may occur in a healthcare facility in a manner different from that in a urban community setting due to different network architecture. We simulate stochastic susceptible-infected-recovered dynamics on social networks, which are based on observations in a hospital in Tokyo, to explore effective containment strategies against nosocomial infection. The observed social networks in the hospital have hierarchical and modular structure in which dense substructure such as departments, wards, and rooms, are globally but only loosely connected, and do not reveal extremely right-skewed distributions of the number of contacts per individual. We show that healthcare workers, particularly medical doctors, are main vectors (i.e. transmitters) of diseases on these networks. Intervention methods that restrict interaction between medical doctors and their visits to different wards shrink the final epidemic size more than intervention methods that directly protect patients, such as isolating patients in single rooms. By the same token, vaccinating doctors with priority rather than patients or nurses is more effective. Finally, vaccinating individuals with large betweenness centrality (frequency of mediating connection between pairs of individuals along the shortest paths) is superior to vaccinating ones with large connectedness to others or randomly chosen individuals, which was suggested by previous model studies.

  9. Satisfaction, motivation, and intent to stay among Ugandan physicians: a survey from 18 national hospitals.

    Science.gov (United States)

    Luboga, Sam; Hagopian, Amy; Ndiku, John; Bancroft, Emily; McQuide, Pamela

    2011-01-01

    Uganda faces a colossal shortages of human resources for health. Previous literature has largely focused on those who leave. This paper reports on a study of physicians working in 18 public and private facilities in Uganda as part of a larger study of more than 641 hospital-based health workers in Uganda. We report what could entice physicians to stay longer, satisfaction with current positions, and future career intentions. This study took place in 18 Ugandan hospitals. We describe the 49 physicians who participated in 11 focus groups and the 63 physicians who completed questionnaires, out of a larger sample of 641 health workers overall. Only 37% of physicians said they were satisfied with their jobs, and 46% reported they were at risk of leaving the health sector or the country. After compensation, the largest contributors to dissatisfaction among physicians were quality of management, availability of equipment and supplies (including drugs), quality of facility infrastructure, staffing and workload, political influence, community location, and professional development. Physicians in our study were highly dissatisfied, with almost half the sample reporting a risk to leave the sector or the country. The established link in literature between physician dissatisfaction and departure from the health system suggests national and regional policy makers should consider interventions that address the contributors to dissatisfaction identified in our study. Copyright © 2010 John Wiley & Sons, Ltd.

  10. Notifications of hospital events to outpatient clinicians using health information exchange: a post-implementation survey

    Directory of Open Access Journals (Sweden)

    Richard Altman

    2013-09-01

    Full Text Available Background The trend towards hospitalist medicine can lead to disjointed patient care. Outpatient clinicians may be unaware of patients’ encounters with a disparate healthcare system. Electronic notifications to outpatient clinicians of patients’ emergency department (ED visits and inpatient admissions and discharges using health information exchange can inform outpatient clinicians of patients’ hospital-based events.Objective Assess outpatient clinicians’ impressions of a new, secure messaging-based, patient event notification system.Methods Twenty outpatient clinicians receiving notifications of hospital-based events were recruited and 14 agreed to participate. Using a semi-structured interview, clinicians were asked about their use of notifications and the impact on their practices.Results Nine of 14 interviewed clinicians (64% thought that without notifications, they would have heard about fewer than 10% of ED visits before the patient’s next visit. Nine clinicians (64% thought that without notifications, they would have heard about fewer than 25% of inpatient admissions and discharges before the patient’s next visit. Six clinicians (43% reported that they call the inpatient team more often because of notifications. Eight users (57% thought that notifications improved patient safety by increasing their awareness of the patients’ clinical events and their medication changes. Key themes identified were the importance of workflow integration and a desire for more clinical information in notifications.Conclusions The notification system is perceived by clinicians to be of value. These findings should instigate further message-oriented use of health information exchange and point to refinements that can lead to even greater benefits.

  11. Administrative management of dental departments in hospitals in Taiwan: A field survey

    Directory of Open Access Journals (Sweden)

    Tsang-Lie Cher

    2012-12-01

    Conclusion: For the overall administrative management of dental departments, medical centers were superior to regional hospitals, which were better than district hospitals. In order to elevate the quality, we suggest that dental department should be included in teaching hospital accreditation, and the criteria we used can be taken for reference for the dental department accreditation in the future.

  12. Simulating the Performance of Ground-Based Optical Asteroid Surveys

    Science.gov (United States)

    Christensen, Eric J.; Shelly, Frank C.; Gibbs, Alex R.; Grauer, Albert D.; Hill, Richard E.; Johnson, Jess A.; Kowalski, Richard A.; Larson, Stephen M.

    2014-11-01

    We are developing a set of asteroid survey simulation tools in order to estimate the capability of existing and planned ground-based optical surveys, and to test a variety of possible survey cadences and strategies. The survey simulator is composed of several layers, including a model population of solar system objects and an orbital integrator, a site-specific atmospheric model (including inputs for seeing, haze and seasonal cloud cover), a model telescope (with a complete optical path to estimate throughput), a model camera (including FOV, pixel scale, and focal plane fill factor) and model source extraction and moving object detection layers with tunable detection requirements. We have also developed a flexible survey cadence planning tool to automatically generate nightly survey plans. Inputs to the cadence planner include camera properties (FOV, readout time), telescope limits (horizon, declination, hour angle, lunar and zenithal avoidance), preferred and restricted survey regions in RA/Dec, ecliptic, and Galactic coordinate systems, and recent coverage by other asteroid surveys. Simulated surveys are created for a subset of current and previous NEO surveys (LINEAR, Pan-STARRS and the three Catalina Sky Survey telescopes), and compared against the actual performance of these surveys in order to validate the model’s performance. The simulator tracks objects within the FOV of any pointing that were not discovered (e.g. too few observations, too trailed, focal plane array gaps, too fast or slow), thus dividing the population into “discoverable” and “discovered” subsets, to inform possible survey design changes. Ongoing and future work includes generating a realistic “known” subset of the model NEO population, running multiple independent simulated surveys in coordinated and uncoordinated modes, and testing various cadences to find optimal strategies for detecting NEO sub-populations. These tools can also assist in quantifying the efficiency of novel

  13. Electronic health record use in an affluent region in India: Findings from a survey of Chandigarh hospitals.

    Science.gov (United States)

    Powell, Adam C; Ludhar, Jasmine K; Ostrovsky, Yuri

    2017-07-01

    To characterize the electronic health record (EHR) systems in use in an affluent region of India in order to understand the state-of-the-art within the Indian market. A survey on EHR features was created by combining an instrument developed by the Organisation for International Cooperation and Development and an instrument developed by an American team of researchers. An interviewer directly administered the survey to leaders from hospitals in greater Chandigarh which possessed electronic health information systems. Summary statistics from the survey are reported. 24 hospitals offering multi-specialty inpatient care were identified in greater Chandigarh. 18 of these hospitals had electronic health information systems, 17 of which were interviewed. Of the hospitals with systems, 17 (100%) could access patient demographic information internally, but 12 (71%) could not access vital sign, allergy, or immunization data internally. 11 (65%) of the systems were capable of sharing patient summaries internally, but 13 (76%) could not send electronic referrals internally. Among organizations which have adopted systems, major barriers tend to have been around financial and staff matters. Concerns over interoperability, privacy, and security were infrequently cited as barriers to adoption. EHRs are ubiquitous in at least one region of India. Systems are more likely to have capabilities for intra-organizational information sharing than for inter-organizational information sharing. The availability of EHR data may foster clinical research. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Parental experiences with a hospital-based bead programme for children with congenital heart disease.

    Science.gov (United States)

    Wilson, Valerie; Chando, Shingisai

    2015-02-01

    To present survey findings on parental experiences with a hospital-based bead programme for children with congenital heart disease. The Heart Beads programme commenced at a paediatric hospital in Australia in 2008. Children enrolled in the programme are awarded a distinctive bead for every procedure/treatment they have while in hospital. A previous evaluation study on the programme revealed that the beads are therapeutic for the child and parents; however, due to a small sample size, the results were representative of the experiences of a small number of families who participated in the programme. This was an evaluation study which employed a nonexperimental descriptive design. Surveys were mailed to all eligible families who enrolled in the programme. Data collection occurred between July-December 2012. Questions on parental experiences with the Heart Beads programme were divided into three categories: understanding, acknowledgement and quality. Descriptive statistics were obtained and analysed. One hundred and sixty-two mothers and 136 fathers responded to the survey. Heart Beads assisted mothers (83%) and fathers (80%) with understanding their child's condition and helped them with communication (mothers 80%, fathers 58%). The majority of fathers felt that their experience was acknowledged by nursing staff (64%) and medical staff (62%), while mothers indicated a higher response from nurses (76%) compared to medical staff (67%). Overall, parents rated the programme positively; however, there was some concern that children at times missed out on beads. Understanding how mothers and fathers experience the programme differently can guide staff in their communication with parents and inform future initiatives. The Heart Beads help nurses understand how parents are experiencing care and ways in which they can provide support and acknowledgement of the parent's experience. © 2014 John Wiley & Sons Ltd.

  15. Beyond the bundle: a survey of central line-associated bloodstream infection prevention practices used in US and Canadian pediatric hospitals.

    Science.gov (United States)

    Klieger, Sarah B; Potter-Bynoe, Gail; Quach, Caroline; Sandora, Thomas J; Coffin, Susan E

    2013-11-01

    We surveyed US and Canadian pediatric hospitals about their use of central line-associated bloodstream infection (CLABSI) prevention strategies beyond typical insertion and maintenance bundles. We found wide variation in supplemental strategies across hospitals and in their penetration within hospitals. Future studies should assess specific adjunctive prevention strategies and CLABSI rates.

  16. The adoption of provider-based rural health clinics by rural hospitals: a study of market and institutional forces.

    Science.gov (United States)

    Krein, S L

    1999-04-01

    To examine the response of rural hospitals to various market and organizational signals by determining the factors that influence whether or not they establish a provider-based rural health clinic (RHC) (a joint Medicare/Medicaid program). Several secondary sources for 1989-1995: the AHA Annual Survey, the PPS Minimum Data Set and a list of RHCs from HCFA, the Area Resource File, and professional associations. The analysis includes all general medical/surgical rural hospitals operating in the United States during the study period. A longitudinal design and pooled cross-sectional data were used, with the rural hospital as the unit of analysis. Key variables were examined as sets and include measures of competitive pressures (e.g., hospital market share), physician resources, nurse practitioner/physician assistant (NP/PA) practice regulation, hospital performance pressures (e.g., operating margin), innovativeness, and institutional pressure (i.e., the cumulative force of adoption). Adoption of provider-based RHCs by rural hospitals appears to be motivated less as an adaptive response to observable economic or internal organizational signals than as a reaction to bandwagon pressures. Rural hospitals with limited resources may resort to imitating others because of uncertainty or a limited ability to fully evaluate strategic activities. This can result in actions or behaviors that are not consistent with policy objectives and the perceived need for policy changes. Such activity in turn could have a negative effect on some providers and some rural residents.

  17. High rate of burnout among anaesthesiologists in Belgrade teaching hospitals: Results of a cross-sectional survey.

    Science.gov (United States)

    Milenović, Miodrag; Matejić, Bojana; Vasić, Vladimir; Frost, Elizabeth; Petrović, Nataša; Simić, Dušica

    2016-03-01

    Decisions by anaesthesiologists directly impact the treatment, safety, recovery and quality of life of patients. Physical or mental collapse due to overwork or stress (burnout) in anaesthesiologists may, therefore, be expected to negatively affect patients, departments, healthcare facilities and families. To evaluate the prevalence of burnout among anaesthesiologists in Belgrade public teaching hospitals. A cross-sectional survey. Anaesthesiologists in 10 Belgrade teaching hospitals. Burnout was assessed using Maslach Burnout Inventory-Human Services Survey. The response rate was 76.2% (205/272) with the majority of respondents women (70.7%). The prevalence of total burnout among anaesthesiologists in Belgrade teaching hospitals was 6.34%. Measured level of burnout as assessed by high emotional exhaustion, high depersonalisation and low personal accomplishment was 52.7, 12.2 and 28.8%, respectively. More than a quarter of the studied population responded in each category with symptoms of moderate burnout. We detected that sex, additional academic education, marital status and working conditions were risk factors for emotional exhaustion and depersonalisation. Ageing increased the likelihood of burnout by 21.3% with each additional year. Shorter professional experience and increased educational accomplishment increased the risk of total burnout by 272%. Burnout rates in Belgrade teaching hospitals among anaesthesiologists are higher than in foreign hospitals. Emotional and/or physical breakdowns can have serious effects when these individuals care for patients in extremely stressed situations that may occur perioperatively. Causes for burnout should be examined more closely and means implemented to reverse this process.

  18. [Satisfaction survey in general hospital personnel involved in blood transfusion: implementation of the ISO 9001: 2000 standard].

    Science.gov (United States)

    Chord-Auger, S; de Bouchony, E Tron; Moll, M-C; Boudart, D; Folléa, G

    2004-07-01

    As part of its policy of constant quality improvement, Etablissement Français du Sang (EFS) des Pays de la Loire (Pays de la Loire Regional blood transfusion institution) carried out a satisfaction survey among the hospital personnel involved in prescribing and using immuno-hematological tests and labile blood products. The polling tool selected by agreement between the hospital management and quality assurance department was a questionnaire that permitted item rating and free commentary. It addressed the personnel's perception of the quality of erythrocyte immuno-hematological (EIH) testing and of the products administered, as well as their perception of the quality of communications with the local EFS. The questionnaire was sent to 26 physicians and 32 senior nurses in 15 hospital departments. The reply rate was 60% and expressed a 85% overall satisfaction level. Dissatisfaction causes were more specifically analysed, the main one involving labile blood product distribution in emergency situations. A joint undertaking by the EFS and the hospital led to the implementation of corrective measures, including the writing and implementation of a common standard operating procedure for emergency transfusion management. The results obtained demonstrated the feasibility of this type of survey and the interest, to a blood transfusion centre and the hospital personnel involved in transfusion, of assessing their very own perception of service quality.

  19. Satisfaction survey in general hospital personnel involved in blood transfusion: implementation of the ISO 9001: 2000 standard.

    Science.gov (United States)

    Chord-Auger, S; Tron de Bouchony, E; Moll, M C; Boudart, D; Folléa, G

    2004-10-01

    As part of its policy of constant quality improvement, Etablissement francais du sang (EFS) des pays de la Loire (Pays de la Loire Regional Blood Transfusion Centre) carried out a satisfaction survey among the hospital personnel involved in prescribing and using immunohaematological tests and labile blood products (LBP). The polling tool selected by agreement between the Saint Nazaire's hospital management and Quality Assurance (QA) Department was a questionnaire that permitted item rating and free commentary. It addressed the personnel's perception of the quality of erythrocyte immunohaematological (EIH) testing and of the products administered, as well as their perception of the quality of communications with the local EFS. The questionnaire was sent to 26 physicians and 32 senior nurses in 15 hospital departments. The reply rate was 60% and expressed an 85% overall satisfaction level. Dissatisfaction causes were more specifically analysed, the main one involving LBP distribution in emergency situations. A joint undertaking by the EFS and the hospital led to the implementation of corrective measures, including the writing and implementation of a common standard operating procedure for emergency transfusion management. The results obtained demonstrated the feasibility of this type of survey and the interest, to a blood transfusion centre and the hospital personnel involved in transfusion, of assessing their very own perception of service quality.

  20. Skills and knowledge of informatics, and training needs of hospital pharmacists in Thailand: A self-assessment survey.

    Science.gov (United States)

    Chonsilapawit, Teeraporn; Rungpragayphan, Suang

    2016-10-01

    Because hospital pharmacists have to deal with large amounts of health information and advanced information technology in practice, they must possess adequate skills and knowledge of informatics to operate efficiently. However, most current pharmacy curricula in Thailand barely address the principles and skills concerned with informatics, and Thai pharmacists usually acquire computer literacy and informatics skills through personal-interest training and self-study. In this study, we aimed to assess the skills and knowledge of informatics and the training needs of hospital pharmacists in Thailand, in order to improve curricular and professional development. A self-assessment postal survey of 73 questions was developed and distributed to the pharmacy departments of 601 hospitals throughout the country. Practicing hospital pharmacists were requested to complete and return the survey voluntarily. Within the 3 months of the survey period, a total of 805 out of 2002 surveys were returned. On average, respondents rated themselves as competent or better in the skills of basic computer operation, the Internet, information management, and communication. Understandably, they rated themselves at novice level for information technology and database design knowledge/skills, and at advanced beginner level for project, risk, and change management skills. Respondents believed that skills and knowledge of informatics were highly necessary for their work, and definitely needed training. Thai hospital pharmacists were confident in using computers and the Internet. They realized and appreciated their lack of informatics knowledge and skills, and needed more training. Pharmacy curricula and training should be developed accordingly. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Joint analyses of open comments and quantitative data: Added value in a job satisfaction survey of hospital professionals.

    Directory of Open Access Journals (Sweden)

    Ingrid Gilles

    Full Text Available To obtain a comprehensive understanding of the job opinions of hospital professionals by conducting qualitative analyses of the open comments included in a job satisfaction survey and combining these results with the quantitative results.A cross-sectional survey targeting all Lausanne University Hospital professionals was performed in the fall of 2013.The survey considered ten job satisfaction dimensions (e.g. self-fulfilment, workload, management, work-related burnout, organisational commitment, intent to stay and included an open comment section. Computer-assisted qualitative analyses were conducted on these comments. Satisfaction rates on the included dimensions and professional groups were entered as predictive variables in the qualitative analyses.Of 10 838 hospital professionals, 4978 participated in the survey and 1067 provided open comments. Data from 1045 respondents with usable comments constituted the analytic sample (133 physicians, 393 nurses, 135 laboratory technicians, 247 administrative staff, including researchers, 67 logistic staff, 44 psycho-social workers, and 26 unspecified.Almost a third of the comments addressed scheduling issues, mostly related to problems and exhaustion linked to shifts, work-life balance, and difficulties with colleagues' absences and the consequences for quality of care and patient safety. The other two-thirds related to classic themes included in job satisfaction surveys. Although some comments were provided equally by all professional groups, others were group specific: work and hierarchy pressures for physicians, healthcare quality and patient safety for nurses, skill recognition for administrative staff. Overall, respondents' comments were consistent with their job satisfaction ratings.Open comment analysis provides a comprehensive understanding of hospital professionals' job experiences, allowing better consideration of quality initiatives that match the needs of professionals with reality.

  2. Joint analyses of open comments and quantitative data: Added value in a job satisfaction survey of hospital professionals.

    Science.gov (United States)

    Gilles, Ingrid; Mayer, Mauro; Courvoisier, Nelly; Peytremann-Bridevaux, Isabelle

    2017-01-01

    To obtain a comprehensive understanding of the job opinions of hospital professionals by conducting qualitative analyses of the open comments included in a job satisfaction survey and combining these results with the quantitative results. A cross-sectional survey targeting all Lausanne University Hospital professionals was performed in the fall of 2013. The survey considered ten job satisfaction dimensions (e.g. self-fulfilment, workload, management, work-related burnout, organisational commitment, intent to stay) and included an open comment section. Computer-assisted qualitative analyses were conducted on these comments. Satisfaction rates on the included dimensions and professional groups were entered as predictive variables in the qualitative analyses. Of 10 838 hospital professionals, 4978 participated in the survey and 1067 provided open comments. Data from 1045 respondents with usable comments constituted the analytic sample (133 physicians, 393 nurses, 135 laboratory technicians, 247 administrative staff, including researchers, 67 logistic staff, 44 psycho-social workers, and 26 unspecified). Almost a third of the comments addressed scheduling issues, mostly related to problems and exhaustion linked to shifts, work-life balance, and difficulties with colleagues' absences and the consequences for quality of care and patient safety. The other two-thirds related to classic themes included in job satisfaction surveys. Although some comments were provided equally by all professional groups, others were group specific: work and hierarchy pressures for physicians, healthcare quality and patient safety for nurses, skill recognition for administrative staff. Overall, respondents' comments were consistent with their job satisfaction ratings. Open comment analysis provides a comprehensive understanding of hospital professionals' job experiences, allowing better consideration of quality initiatives that match the needs of professionals with reality.

  3. A Survey of Technologies Supporting Virtual Project Based Learning

    DEFF Research Database (Denmark)

    Dirckinck-Holmfeld, Lone

    2002-01-01

    This paper describes a survey of technologies and to what extent they support virtual project based learning. The paper argues that a survey of learning technologies should be related to concrete learning tasks and processes. Problem oriented project pedagogy (POPP) is discussed, and a framework...... for evaluation is proposed where negotiation of meaning, coordination and resource management are identified as the key concepts in virtual project based learning. Three e-learning systems are selected for the survey, Virtual-U, Lotus Learningspace and Lotus Quickplace, as each system offers different strategies...... for e-learning. The paper concludes that virtual project based learning may benefit from facilities of all these systems....

  4. Patient satisfaction with a hospital-based neuropsychology service.

    Science.gov (United States)

    Foran, Amie; Millar, Elisa; Dorstyn, Diana

    2016-09-01

    Objective The aim of the present study was to develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to the neuropsychological assessment process. Methods A focus group of out-patients (n=15) was surveyed to identify the factors commonly associated with a satisfactory neuropsychological experience. Responses informed a purposely designed 14-item patient satisfaction scale (α=0.88) that was completed by 66 hospital out-patients with mild to moderate cognitive impairment. Results Satisfaction with the neuropsychological assessment process was generally reported, with the testing phase (85%) rated significantly more favourably than the pre-assessment (79%) and feedback (70%) phases. Commentaries provided by 32 respondents identified interpersonal facilitators to a satisfactory neuropsychological assessment experience, but also dissatisfaction with physical aspects of the testing environment in addition to service availability. Conclusions The patient satisfaction scale can be used as a quality assurance tool to evaluate neuropsychological service delivery. Large-scale research is needed to confirm the scale's psychometric properties. Further research may also include a broader perspective on the consumers' experience of neuropsychological services.

  5. Comparing econometric and survey-based methodologies in measuring offshoring

    DEFF Research Database (Denmark)

    Refslund, Bjarke

    2016-01-01

    such as the national or regional level. Most macro analyses are based on proxies and trade statistics with limitations. Drawing on unique Danish survey data, this article demonstrates how survey data can provide important insights into the national scale and impacts of offshoring, including changes of employment...

  6. Conducting Surveys and Data Collection: From Traditional to Mobile and SMS-based Surveys

    Directory of Open Access Journals (Sweden)

    Iftikhar Alam

    2014-08-01

    Full Text Available Fresh, bias-free and valid data collected using different survey modes is considered an essential requirement for smooth functioning and evolution of an organization. Surveys play a major role in making in-time correct decisions and generating reports. The aim of this study is to compare and investigate state-of-the-art in different survey modes including print, email, online, mobile and SMS-based surveys. Results indicated that existing methods are neither complete nor sufficient to fulfil the overall requirements of an organization which primarily rely on surveys. Also, it shows that SMS is a dominant method for data collection due to its pervasiveness. However, existing SMS-based data collection has limitations like limited number of characters per SMS, single question per SMS and lake of multimedia support. Recent trends in data collection emphasis on data collection applications for smart phones. However, in developing countries low-end mobile devices are still extensively used which makes the data collection difficult from man in the street. The paper conclude that existing survey modes and methods should be improved to get maximum responses quickly in low cost manner. The study has contributed to the area of surveying and data collection by analysing different factors such as cost, time and response rate. The results of this study can help practitioners in creating a more successful surveying method for data collection that can be effectively used for low budget projects in developed as well as developing countries.

  7. FACTORS AFFECTING IMPLEMENTATION OF EVIDENCE BASED PRACTICE AMONG PHYSIOTHERAPISTS IN MOI TEACHING REFFERAL HOSPITAL KENYA

    Directory of Open Access Journals (Sweden)

    Naomi Wanjiru

    2016-06-01

    Full Text Available Background: The application of the concept of Evidenced Based Practice into clinical decision-making and practicehas outstanding benefits both to clinicians and the patient. However, the utilization of this concept has not been copiously utilized in most health facilities by the physiotherapists in Kenya. Therefore, the objectives for this study was to determine the level of awareness of evidence based practice among Physiotherapist, establish the availability of resource for Evidence Based Practice and to assess the challenges encountered by physiotherapist in engaging in evidence based practice at Moi Teaching and Referral Hospital. Methods: All physiotherapists working in Moi Teaching and Referral Hospital (42 took part in a cross-sectional descriptive survey. Questionnaires were used for data collection and analyzed by SPSS version 22. Results: there was high level of awareness on Evidence Based Practice (95 % and confidence in EBP (72.5 %. However, lack of information resources, poor skills to implement EBP, poor organization support 90%, insufficient authority to induct change in the practice setting 85%, inadequate facilities 74% and lack of time were identified as the major challenges in implementation of EBP Conclusion: Strategies should be developed to provide PTs with EBP resources, such as access to databases or links to guidelines, and continuous education regarding specific topics. Professional organizations and Associations should aim at changing the current practice to ensure full utilization of EBP.

  8. Evaluation of health care providers’ role transition and satisfaction in hospital-at-home for chronic obstructive pulmonary disease exacerbations: a survey study

    Science.gov (United States)

    2013-01-01

    Background Hospital-at-home is an accepted alternative for usual hospital treatment for patients with a Chronic Obstructive Pulmonary Disease (COPD) exacerbation. The introduction of hospital-at-home may lead to changes in health care providers’ roles and responsibilities. To date, the impact on providers’ roles is unknown and in addition, little is known about the satisfaction and acceptance of care providers involved in hospital-at-home. Methods Objective of this survey study was to investigate the role differentiation, role transitions and satisfaction of professional care providers (i.e. pulmonologists, residents, hospital respiratory nurses, generic and specialised community nurses and general practitioners) from 3 hospitals and 2 home care organisations, involved in a community-based hospital-at-home scheme. A combined multiple-choice and open-end questionnaire was administered in study participants. Results Response rate was 10/17 in pulmonologists, 10/23 in residents, 9/12 in hospital respiratory nurses, 15/60 in generic community nurses, 6/10 in specialised community nurses and 25/47 in general practitioners. For between 66% and 100% of respondents the role in early discharge was clear and between 57% and 78% of respondents was satisfied with their role in early discharge. For nurses the role in early discharge was different compared to their role in usual care. 67% of generic community nurses felt they had sufficient knowledge and skills to monitor patients at home, compared to 100% of specialised community nurses. Specialised community nurses felt they should monitor patients. 60% of generic community nurses responded they should monitor patients at home. 78% of pulmonologists, 12% of general practitioners, 55% of hospital respiratory nurses and 48 of community nurses was satisfied with early discharge in general. For coordination of care 29% of community nurses had an unsatisfied response. For continuity of care this was 12% and 10% for hospital

  9. Hospital Value-Based Purchasing (HVBP) – Total Performance Score

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals participating in the Hospital VBP Program and their Clinical Process of Care domain scores, Patient Experience of Care dimension scores, and...

  10. Hospital Value-Based Purchasing (HVBP) – Heart Failure Scores

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals participating in the Hospital VBP Program and their performance rates and scores for the Clinical Process of Care Heart Failure measures.

  11. Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil.

    Science.gov (United States)

    Lovisi, Giovanni Marcos; López, José Ramon R A; Coutinho, Evandro Silva Freire; Patel, Vikram

    2005-10-01

    Depression in women is associated with social deprivation and violence. We describe the prevalence and risk factors for depression during pregnancy, in particular the association with poverty and violence, in a Brazilian setting. A cross-sectional survey of women in the third trimester of pregnancy attending a public hospital maternity clinic from August 2003 to July 2004 in Rio de Janeiro. Participants were interviewed about their sociodemographic status, obstetric and medical conditions, substance use, stressful life events, and social support. Depression was diagnosed through the Composite International Diagnostic Interview (CIDI). A total of 230 of 240 eligible women consented to participate. The 12-month prevalence of depression was 19.1% (95% CI 14.4-24.9). On multivariate analyses, having been educated beyond primary school was protective (OR 0.5, 95% CI 0.2-0.9). Risk factors were: being divorced or widowed (OR 4.9, 95% CI 1.3-18.3); a history of depression before pregnancy (OR 7.9, 95% CI 3.1-20.5); loss of an intimate relationship (OR 8.4, 95% CI 3.3-21.4), experienced financial difficulties (OR 6.6, 95% CI 2.5-17.2) and having been exposed to violence in the previous year (OR 4.2, 95% CI 1.5-11.8). Depression is common during pregnancy and is associated with indicators of socio-economic deprivation, violence and the loss of an intimate relationship, and with a previous history of depression. Psychosocial interventions and appropriate social policies need to be implemented in this population to reduce the burden of maternal depression.

  12. Linguistic Validation and Cultural Adaptation of Bulgarian Version of Hospital Survey on Patient Safety Culture (HSOPSC).

    Science.gov (United States)

    Stoyanova, Rumyana; Dimova, Rositsa; Tarnovska, Miglena; Boeva, Tatyana

    2018-05-20

    Patient safety (PS) is one of the essential elements of health care quality and a priority of healthcare systems in most countries. Thus the creation of validated instruments and the implementation of systems that measure patient safety are considered to be of great importance worldwide. The present paper aims to illustrate the process of linguistic validation, cross-cultural verification and adaptation of the Bulgarian version of the Hospital Survey on Patient Safety Culture (B-HSOPSC) and its test-retest reliability. The study design is cross-sectional. The HSOPSC questionnaire consists of 42 questions, grouped in 12 different subscales that measure patient safety culture. Internal con-sistency was assessed using Cronbach's alpha. The Wilcoxon signed-rank test and the split-half method were used; the Spear-man-Brown coefficient was calculated. The overall Cronbach's alpha for B-HSOPSC is 0.918. Subscales 7 Staffing and 12 Overall perceptions of safety had the lowest coefficients. The high reliability of the instrument was confirmed by the Split-half method (0.97) and ICC-coefficient (0.95). The lowest values of Spearmen-Broun coefficients were found in items A13 and A14. The study offers an analysis of the results of the linguistic validation of the B-HSOPSC and its test-retest reliability. The psychometric characteristics of the questions revealed good validity and reliability, except two questions. In the future, the instrument will be administered to the target population in the main study so that the psychometric properties of the instrument can be verified.

  13. Urinary incontinence: hospital-based prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Marzieh Nojomi

    2008-02-01

    trauma, constipation, chronic illnesses (specially diabetes, and gynecologic and other pelvic surgeries.

  14. KEY WORDS: Urinary incontinence, prevalence, risk factors, hospital-based.
  15. Evaluation of a Hospital-Based Pneumonia Nurse Navigator Program.

    Science.gov (United States)

    Seldon, Lisa E; McDonough, Kelly; Turner, Barbara; Simmons, Leigh Ann

    2016-12-01

    The aim of this study is to evaluate the effectiveness of a hospital-based pneumonia nurse navigator program. This study used a retrospective, formative evaluation. Data of patients admitted from January 2012 through December 2014 to a large community hospital with a primary or secondary diagnosis of pneumonia, excluding aspiration pneumonia, were used. Data included patient demographics, diagnoses, insurance coverage, core measures, average length of stay (ALOS), disposition, readmission rate, financial outcomes, and patient barriers to care were collected. Descriptive statistics and parametric testing were used to analyze data. Core measure performance was sustained at the 90th percentile 2 years after the implementation of the navigator program. The ALOS did not decrease to established benchmarks; however, the SD for ALOS decreased by nearly half after implementation of the navigator program, suggesting the program decreased the number and length of extended stays. Charges per case decreased by 21% from 2012 to 2014. Variable costs decreased by 4% over a 2-year period, which increased net profit per case by 5%. Average readmission payments increased by 8% from 2012 to 2014, and the net revenue per case increased by 8.3%. The pneumonia nurse navigator program may improve core measures, reduce ALOS, and increase net revenue. Future evaluations are necessary to substantiate these findings and optimize the cost and quality performance of navigator programs.

  16. Convenience Sampling of Children Presenting to Hospital-Based Outpatient Clinics to Estimate Childhood Obesity Levels in Local Surroundings.

    Science.gov (United States)

    Gilliland, Jason; Clark, Andrew F; Kobrzynski, Marta; Filler, Guido

    2015-07-01

    Childhood obesity is a critical public health matter associated with numerous pediatric comorbidities. Local-level data are required to monitor obesity and to help administer prevention efforts when and where they are most needed. We hypothesized that samples of children visiting hospital clinics could provide representative local population estimates of childhood obesity using data from 2007 to 2013. Such data might provide more accurate, timely, and cost-effective obesity estimates than national surveys. Results revealed that our hospital-based sample could not serve as a population surrogate. Further research is needed to confirm this finding.

  17. The role of leader behaviors in hospital-based emergency departments' unit performance and employee work satisfaction.

    Science.gov (United States)

    Lin, Blossom Yen-Ju; Hsu, Chung-Ping C; Juan, Chi-Wen; Lin, Cheng-Chieh; Lin, Hung-Jung; Chen, Jih-Chang

    2011-01-01

    The role of the leader of a medical unit has evolved over time to expand from simply a medical role to a more managerial one. This study aimed to explore how the behavior of a hospital-based emergency department's (ED's) leader might be related to ED unit performance and ED employees' work satisfaction. One hundred and twelve hospital-based EDs in Taiwan were studied: 10 in medical centers, 32 in regional hospitals, and 70 in district hospitals. Three instruments were designed to assess leader behaviors, unit performance and employee satisfaction in these hospital-based EDs. A mail survey revealed that task-oriented leader behavior was positively related to ED unit performance. Both task- and employee-oriented leader behaviors were found to be positively related to ED nurses' work satisfaction. However, leader behaviors were not shown to be related to ED physicians' work satisfaction at a statistically significant level. Some ED organizational characteristics, however, namely departmentalization and hospital accreditation level, were found to be related to ED physicians' work satisfaction. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. GUIDING PRINCIPLES FOR GOOD PRACTICES IN HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT UNITS.

    Science.gov (United States)

    Sampietro-Colom, Laura; Lach, Krzysztof; Pasternack, Iris; Wasserfallen, Jean-Blaise; Cicchetti, Americo; Marchetti, Marco; Kidholm, Kristian; Arentz-Hansen, Helene; Rosenmöller, Magdalene; Wild, Claudia; Kahveci, Rabia; Ulst, Margus

    2015-01-01

    Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units. A framework for good practice criteria was built inspired by the EFQM excellence business model and information from six literature reviews, 107 face-to-face interviews, forty case studies, large-scale survey, focus group, Delphi survey, as well as local and international validation. In total, 385 people from twenty countries have participated in defining the principles for good practices in HB-HTA units. Fifteen guiding principles for good practices in HB-HTA units are grouped in four dimensions. Dimension 1 deals with principles of the assessment process aimed at providing contextualized information for hospital decision makers. Dimension 2 describes leadership, strategy and partnerships of HB-HTA units which govern and facilitate the assessment process. Dimension 3 focuses on adequate resources that ensure the operation of HB-HTA units. Dimension 4 deals with measuring the short- and long-term impact of the overall performance of HB-HTA units. Finally, nine core guiding principles were selected as essential requirements for HB-HTA units based on the expertise of the HB-HTA units participating in the project. Guiding principles for good practices set up a benchmark for HB-HTA because they represent the ideal performance of HB-HTA units; nevertheless, when performing HTA at hospital level, context also matters; therefore, they should be adapted to ensure their applicability in the local context.

  19. Assessment of evidence-based practice among hospital pharmacists in Saudi Arabia: attitude, awareness, and practice.

    Science.gov (United States)

    Al-Jazairi, Abdulrazaq S; Alharbi, Reem

    2017-08-01

    Background Many studies have previously looked at the perceptions, attitude, and use of Evidence-based Practice (EBP) among healthcare providers. However, limited data is available on the implementation of EBP among pharmacists in general, and Saudi Arabia in particular. Objective To evaluate the awareness, attitude, and practice of EBP among hospital practicing pharmacists in Saudi Arabia. Setting Secondary and tertiary care hospitals in Saudi Arabia with a bed capacity of ≥200 Methods This is a cross sectional, survey-based study where a validated selfadministrated questionnaire was utilized. Pharmacists working in secondary and tertiary care hospitals with a bed capacity of ≥200 were targeted. The descriptive data consisted of percentages for discrete and medians for continuous statistics. Results The survey was distributed to a total of 1136 pharmacists. Total number of respondents is 228 which represent a response rate of 20%. Most of them (75% median score = 8) have a positive attitude toward EBP. In addition to clinical expertise, only 48.6% of them were able to identify EBP resource as the second component of EBP concept, while only 1.7% of the respondents were able to identify patient preference as a third component. Lack of personal time, critical appraisal skills, and resources, (40%, 15.6% and 13.9% respectively) are considered as the major barriers to implementing EBP in pharmacy. Conclusion The majority of pharmacists in Saudi Arabia hold a positive attitude of EBP. Unfortunately, most of pharmacists do not consider patients' values as a component of EBP. The major barriers to practicing EBP are lack of personal time, critical appraisal skills, and resources availability.

  20. [Exposure to limited resources in the gastroenterology - results of a survey of hospital physicians].

    Science.gov (United States)

    Kerkemeyer, L; Reifferscheid, A; Pomorin, N; Wasem, J

    2016-11-01

    Background and research question: The hospital sector is currently characterized by a high economic pressure. As well the DRG system as the investment financing by the federal states imply financial limitations. Hospitals react to this situation by trying to reduce costs and to increase case volume. It is questionable whether and to what extent patient care and the working conditions of the physicians are affected by these circumstances. Especially, gastroenterological patients were considered to be insufficiently covered by the DRG system in the past. Therefore, this study focuses on the gastroenterology. Method: Based on prior studies and several semi-structured interviews with gastroenterologists working in hospitals a discipline-specific questionnaire was developed. Three versions of the questionnaire were differentiated to correspond to the respective experiences of the target population (chief physician, senior physician, assistant physician). All in all, 1751 members of the "Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten" (DGVS) were addressed. The questionnaire was answered by 642 participants resulting in a response rate of 36.7 %. The answers were interpreted by using descriptive and multivariate analyses. Results: A significant economic pressure is perceived by the participating gastroenterologists. This pressure manifests itself primary in perceived deficits in nursing care and human attention towards the patients. Moreover, the work satisfaction is negatively affected. Identified difficulties in the personnel recruitment can only be partially attributed to economic reasons. However, rationing of services is relatively seldom. Also, a financially-oriented overprovision is not perceived as a primary concern. In general, assistant physicians were a bit more skeptical about the situation in the gastroenterology, e. g. patient care, than the chief physicians. Conclusions: In total, the situation in the

  21. The implementation of DRG-based hospital reimbursement in Switzerland: A population-based perspective.

    Science.gov (United States)

    Busato, André; von Below, Georg

    2010-10-16

    Switzerland introduces a DRG (Diagnosis Related Groups) based system for hospital financing in 2012 in order to increase efficiency and transparency of Swiss health care. DRG-based hospital reimbursement is not simultaneously realized in all Swiss cantons and several cantons already implemented DRG-based financing irrespective of the national agenda, a setting that provides an opportunity to compare the situation in different cantons. Effects of introducing DRGs anticipated for providers and insurers are relatively well known but it remains less clear what effects DRGs will have on served populations. The objective of the study is therefore to analyze differences of volume and major quality indicators of care between areas with or without DRG-based hospital reimbursement from a population based perspective. Small area analysis of all hospitalizations in acute care hospitals and of all consultations reimbursed by mandatory basic health insurance for physicians in own practice during 2003-2007. The results show fewer hospitalizations and a relocation of resources to outpatient care in areas with DRG reimbursement. Overall burden of disease expressed as per capita DRG cost weights was almost identical between the two types of hospital reimbursement and no distinct temporal differences were detected in this respect. But the results show considerably higher 90-day rehospitalization rates in DRG areas. The study provides evidence of both desired and harmful effects related to the implementation of DRGs. Systematic monitoring of outcomes and quality of care are therefore essential elements to maintain in the Swiss health system after DRG's are implemented on a nationwide basis in 2012.

  1. Individual radiation exposure from computed tomography. A survey of paediatric practice in French university hospitals, 2010-2013

    Energy Technology Data Exchange (ETDEWEB)

    Journy, Neige M.Y. [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses (France). Lab. d' Epidemiologie des Rayonnements Ionisants; National Institutes of Health, Bethesda, MD (United States). Div. of Cancer Epidemiology and Genetics; Dreuil, Serge [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses (France). Unite d' Expertise en Radioprotection Medicale; Boddaert, Nathalie [Hopital Universitaire Necker Enfants Malades, Paris (France). Service de Radiologie Pediatrique, INSERM U1000, UMR 1163; Cite Univ. Rene Descartes, Paris (France). PRES Sorbonne Paris; Chateil, Jean-Francois [Centre Hospitalier Universitaire de Bordeaux (France). Service de Radiologie et d' Imagerie Antenatale, de l' Enfant et de la Femme; Defez, Didier [Centre Hospitalier Lyon Sud, Pierre-Benite (France). Service de Physique Medicale; Ducou-le-Pointe, Hubert [Hopital d' Enfants Armand-Trousseau, Paris (France). Service de Radiologie; Garcier, Jean-Marc [Centre Hospitalier Universitaire Estaing, Clermont-Ferrand (France). Service de Radiologie; Guersen, Joel [Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand (France). Pole Imagerie et Radiologie Interventionnelle; Habib Geryes, Bouchra [Hopital Universitaire Necker Enfants Malades, Paris (France). Direction des Affaires Medicales, de la Qualite et la Relation avec les Usagers; Jahnen, Andreas [Luxembourg Institute of Science and Technology (LIST), Esch/Alzette (Luxembourg); Lee, Choonsik [National Institutes of Health, Bethesda, MD (United States). Div. of Cancer Epidemiology and Genetics; Payen-de-la-Garanderie, Jacqueline; Pracros, Jean-Pierre [Hopital Femme Mere Enfants, Bron (France). Service d' Imagerie Pediatrique; Sirinelli, Dominique [Centre Hospitalier Regional Universitaire de Tours (France). Service de Radiologie Pediatrique, Hopital Clocheville; Thierry-Chef, Isabelle [International Agency for Research on Cancer, Lyon (France). Section of Environment and Cancer; Bernier, Marie-Odile [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses (France). Lab. d' Epidemiologie des Rayonnements Ionisants

    2018-02-15

    To describe computed tomography (CT) scanning parameters, volume CT dose index (CTDIvol) and dose-length product (DLP) in paediatric practice and compare them to current diagnostic reference levels (DRLs). The survey was conducted in radiology departments of six major university hospitals in France in 2010-2013. Data collection was automatised to extract and standardise information on scanning parameters from DICOM-header files. CTDIvol and DLP were estimated based on Monte Carlo transport simulation and computational reference phantoms. CTDIvol and DLP were derived for 4,300 studies, four age groups and 18 protocols. CTDIvol was lower in younger patients for non-head scans, but did not vary with age for routine head scans. Ratios of 95th to 5th percentile CTDIvol values were 2-4 for most body parts, but 5-7 for abdominal examinations and 4-14 for mediastinum CT with contrast, depending on age. The 75th percentile CTDIvol values were below the national DRLs for chest (all ages) and head and abdominal scans (≥10 years). The results suggest the need for a better optimisation of scanning parameters for routine head scans and infrequent protocols with patient age, enhanced standardisation of practices across departments and revision of current DRLs for children. (orig.)

  2. Individual radiation exposure from computed tomography. A survey of paediatric practice in French university hospitals, 2010-2013

    International Nuclear Information System (INIS)

    Journy, Neige M.Y.; Lee, Choonsik; Payen-de-la-Garanderie, Jacqueline; Pracros, Jean-Pierre; Sirinelli, Dominique; Thierry-Chef, Isabelle; Bernier, Marie-Odile

    2018-01-01

    To describe computed tomography (CT) scanning parameters, volume CT dose index (CTDIvol) and dose-length product (DLP) in paediatric practice and compare them to current diagnostic reference levels (DRLs). The survey was conducted in radiology departments of six major university hospitals in France in 2010-2013. Data collection was automatised to extract and standardise information on scanning parameters from DICOM-header files. CTDIvol and DLP were estimated based on Monte Carlo transport simulation and computational reference phantoms. CTDIvol and DLP were derived for 4,300 studies, four age groups and 18 protocols. CTDIvol was lower in younger patients for non-head scans, but did not vary with age for routine head scans. Ratios of 95th to 5th percentile CTDIvol values were 2-4 for most body parts, but 5-7 for abdominal examinations and 4-14 for mediastinum CT with contrast, depending on age. The 75th percentile CTDIvol values were below the national DRLs for chest (all ages) and head and abdominal scans (≥10 years). The results suggest the need for a better optimisation of scanning parameters for routine head scans and infrequent protocols with patient age, enhanced standardisation of practices across departments and revision of current DRLs for children. (orig.)

  3. Vision-based Vehicle Detection Survey

    Directory of Open Access Journals (Sweden)

    Alex David S

    2016-03-01

    Full Text Available Nowadays thousands of drivers and passengers were losing their lives every year on road accident, due to deadly crashes between more than one vehicle. There are number of many research focuses were dedicated to the development of intellectual driver assistance systems and autonomous vehicles over the past decade, which reduces the danger by monitoring the on-road environment. In particular, researchers attracted towards the on-road detection of vehicles in recent years. Different parameters have been analyzed in this paper which includes camera placement and the various applications of monocular vehicle detection, common features and common classification methods, motion- based approaches and nighttime vehicle detection and monocular pose estimation. Previous works on the vehicle detection listed based on camera poisons, feature based detection and motion based detection works and night time detection.

  4. Still making progress to improve the hospital workplace environment? Results from the 2008 National Survey of Registered Nurses.

    Science.gov (United States)

    Buerhaus, Peter I; DesRoches, Catherine; Donelan, Karen; Hess, Robert

    2009-01-01

    Despite the majority of RNs perceiving a shortage of nurses, findings from the 2008 National Survey of RNs indicate the hospital workplace improved in several areas compared to a 2006 survey. Improvements included the time RNs spend with patients, quality of nursing care, and a decreasing impact of the shortage on delaying nurses' responses to pages or calls, staff communication, patients' wait time for surgery, and timeliness and efficiency of care. Areas the environment was perceived to have worsened included overtime hours, sexual harassment/hostile, and physical violence. RNs hold mixed views about the consequences of reporting errors and mistakes with a majority agreeing that reporting them had led to positive changes to prevent future errors, but that mistakes were held against them. Overall, results suggest that hospital managers can be reassured that their efforts to improve the workplace environment are having their intended effect but, at the same time, important areas for improvement remain.

  5. Cross-sectional survey of patients' need for information and support with medicines after discharge from hospital.

    Science.gov (United States)

    Mackridge, Adam J; Rodgers, Ruth; Lee, Dan; Morecroft, Charles W; Krska, Janet

    2017-11-20

    Most patients experience changes to prescribed medicines during a hospital stay. Ensuring they understand such changes is important for preventing adverse events post-discharge and optimising patient understanding. However, little work has explored the information that patients receive about medicines or their perceived needs for information and support after discharge. To determine information that hospital inpatients who experience medicine changes receive about their medicines during admission and their needs and preferences for, and use of, post-discharge support. Cross-sectional survey with adult medical inpatients experiencing medicine changes in six English hospitals, with telephone follow-up 2-3 weeks post-discharge. A total of 444 inpatients completed surveys, and 99 of these were followed up post-discharge. Of the 444, 44 (10%) were unaware of changes to medicines and 65 (16%) did not recall discussing them with a health professional, but 305 (77%) reported understanding the changes. Type of information provided and patients' perceived need for post-discharge support differed between hospitals. Information about changes was most frequently provided by consultant medical staff (157; 39%) with pharmacists providing information least often (71; 17%). One third of patients surveyed considered community pharmacists as potential sources of information about medicines and associated support post-discharge. Post-discharge, just 5% had spoken to a pharmacist, although 35% reported medicine-related problems. In north-west England, patient inclusion in treatment decisions could be improved, but provision of information prior to discharge is reasonable. There is scope to develop hospital and community pharmacists' role in medicine optimisation to maximise safety and effectiveness of care. © 2017 Royal Pharmaceutical Society.

  6. Correlates of preferences for home or hospital confinement in Pakistan: evidence from a national survey.

    Science.gov (United States)

    Javed, Sajid Amin; Anjum, Muhammad Danish; Imran, Waqas; Haider, Azad; Shiraz, Ayesha; Shaheen, Farzana; Iftikhar ul Husnain, Muhammad

    2013-06-24

    Despite the pregnancy complications related to home births, homes remain yet major place of delivery in Pakistan and 65 percent of totals births take place at home. This work analyses the determinants of place of delivery in Pakistan. Multivariate Logistic regression is used for analysis. Data are extracted from Pakistan Demographic and Health Survey (2006-07). Based on information on last birth preceding 5 years of survey, we construct dichotomous dependent variable i.e. whether women deliver at home (Coded=1) or at health facility (coded=2). Bivariate analysis shows that 72% (p≤0.000) women from rural area and 81% women residing in Baluchistan delivered babies at home. Furthermore 75% women with no formal education, 81% (p≤0.000) women working in agricultural sector, 75% (p≤0.000) of Women who have 5 and more children and almost 77% (p≤0.000) who do not discussed pregnancy related issues with their husbands are found delivering babies at home. Multivariate analysis documents that mothers having lower levels of education, economic status and empowerment, belonging to rural area, residing in provinces other than Punjab, working in agriculture sector and mothers who are young are more likely to give births at home. A trend for home births, among Pakistani women, can be traced in lower levels of education, lower autonomy, poverty driven working in agriculture sector, higher costs of using health facilities and regional backwardness.

  7. Comparison of 16S ribosomal RNA gene sequence analysis and conventional culture in the environmental survey of a hospital

    OpenAIRE

    Manaka, Akihiro; Tokue, Yutaka; Murakami, Masami

    2017-01-01

    Background Nosocomial infection is one of the most common complications within health care facilities. Certain studies have reported outbreaks resulting from contaminated hospital environments. Although the identification of bacteria in the environment can readily be achieved using culturing methods, these methods detect live bacteria. Sequencing of the 16S ribosomal RNA (16S rRNA) gene is recognized to be effective for bacterial identification. In this study, we surveyed wards where drug-res...

  8. Pervasive Computing Support for Hospitals: An Overview of the Activity-Based Computing Project

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak; Bardram, Jakob E

    2007-01-01

    The activity-based computing project researched pervasive computing support for clinical hospital work. Such technologies have potential for supporting the mobile, collaborative, and disruptive use of heterogeneous embedded devices in a hospital......The activity-based computing project researched pervasive computing support for clinical hospital work. Such technologies have potential for supporting the mobile, collaborative, and disruptive use of heterogeneous embedded devices in a hospital...

  9. ARABIC TRANSLATION AND ADAPTATION OF THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) PATIENT SATISFACTION SURVEY INSTRUMENT.

    Science.gov (United States)

    Dockins, James; Abuzahrieh, Ramzi; Stack, Martin

    2015-01-01

    To translate and adapt an effective, validated, benchmarked, and widely used patient satisfaction measurement tool for use with an Arabic-speaking population. Translation of survey's items, survey administration process development, evaluation of reliability, and international benchmarking Three hundred-bed tertiary care hospital in Jeddah, Saudi Arabia. 645 patients discharged during 2011 from the hospital's inpatient care units. INTERVENTIONS; The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was translated into Arabic, a randomized weekly sample of patients was selected, and the survey was administered via telephone during 2011 to patients or their relatives. Scores were compiled for each of the HCAHPS questions and then for each of the six HCAHPS clinical composites, two non-clinical items, and two global items. Clinical composite scores, as well as the two non-clinical and two global items were analyzed for the 645 respondents. Clinical composites were analyzed using Spearman's correlation coefficient and Cronbach's alpha to demonstrate acceptable internal consistency for these items and scales demonstrated acceptable internal consistency for the clinical composites. (Spearman's correlation coefficient = 0.327 - 0.750, P quarterly to US national averages with results that closely paralleled the US benchmarks. . The Arabic translation and adaptation of the HCAHPS is a valid, reliable, and feasible tool for evaluation and benchmarking of inpatient satisfaction in Arabic speaking populations.

  10. Hospital and clinic survey estimates of medical X-ray exposure in Hiroshima and Nagasaki, 2

    International Nuclear Information System (INIS)

    Antoku, Shigetoshi; Hoshi, Masaharu; Sawada, Shozo; Russell, W.J.

    1987-07-01

    The technical factors used during radiological examinations performed in Hiroshima and Nagasaki medical institutions were analyzed. The most frequently performed examination was chest radiography, followed by upper GI series. More than half the radiographic exposures were from upper GI series due to the many spot films made during fluoroscopy. Comparison of the present survey results with those of a previous one showed that relatively high kVp, low mAs and mA, and smaller field sizes are now more widely used. Though there have been decreased in fluoroscopy times and tube currents over the past 10 years, the numbers of spot films used have increased. Based on these technical factors, tables of organ doses from fluoroscopic examinations were compiled. (author)

  11. Quality management and patient safety: survey results from 102 Hungarian hospitals.

    NARCIS (Netherlands)

    Makai, P.; Klazinga, N.; Wagner, C.; Boncz, I.; Gulácsi, L.

    2009-01-01

    OBJECTIVES: The aim of this study is to describe the development of quality management systems in Hungarian hospitals. It also aims to answer the policy question, whether a separate patient safety policy should be created additional to quality policies, on national as well as hospital level. METHOD:

  12. Trauma-informed care for children in the ambulance : international survey among pre-hospital providers

    NARCIS (Netherlands)

    Alisic, Eva; Tyler, Mark P; Giummarra, Melita J; Kassam-Adams, Rahim; Gouweloos, Juul; Landolt, Markus A; Kassam-Adams, Nancy

    2017-01-01

    Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes

  13. Barriers to healthy eating by National Health Service (NHS hospital doctors in the hospital setting: results of a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Wilson Sue

    2008-08-01

    Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

  14. Characterizing hospital workers' willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment

    Directory of Open Access Journals (Sweden)

    Catlett Christina L

    2010-07-01

    Full Text Available Abstract Background Hospital-based providers' willingness to report to work during an influenza pandemic is a critical yet under-studied phenomenon. Witte's Extended Parallel Process Model (EPPM has been shown to be useful for understanding adaptive behavior of public health workers to an unknown risk, and thus offers a framework for examining scenario-specific willingness to respond among hospital staff. Methods We administered an anonymous online EPPM-based survey about attitudes/beliefs toward emergency response, to all 18,612 employees of the Johns Hopkins Hospital from January to March 2009. Surveys were completed by 3426 employees (18.4%, approximately one third of whom were health professionals. Results Demographic and professional distribution of respondents was similar to all hospital staff. Overall, more than one-in-four (28% hospital workers indicated they were not willing to respond to an influenza pandemic scenario if asked but not required to do so. Only an additional 10% were willing if required. One-third (32% of participants reported they would be unwilling to respond in the event of a more severe pandemic influenza scenario. These response rates were consistent across different departments, and were one-third lower among nurses as compared with physicians. Respondents who were hesitant to agree to work additional hours when required were 17 times less likely to respond during a pandemic if asked. Sixty percent of the workers perceived their peers as likely to report to work in such an emergency, and were ten times more likely than others to do so themselves. Hospital employees with a perception of high efficacy had 5.8 times higher declared rates of willingness to respond to an influenza pandemic. Conclusions Significant gaps exist in hospital workers' willingness to respond, and the EPPM is a useful framework to assess these gaps. Several attitudinal indicators can help to identify hospital employees unlikely to respond. The

  15. [Hospital information system performance for road traffic accidents analysis in a hospital recruitment based area].

    Science.gov (United States)

    Jannot, A-S; Fauconnier, J

    2013-06-01

    Road traffic accidents in France are mainly analyzed through reports completed by the security forces (police and gendarmerie). But the hospital information systems can also identify road traffic accidents via specific documentary codes of the International Classification of Diseases (ICD-10). The aim of this study was therefore to determine whether hospital stays consecutive to road traffic accident were truly identified by these documentary codes in a facility that collects data routinely and to study the consistency of results from hospital information systems and from security forces during the 2002-2008 period. We retrieved all patients for whom a documentary code for road traffic accident was entered in 2002-2008. We manually checked the concordance of documentary code for road traffic accident and trauma origin in 350 patient files. The number of accidents in the Grenoble area was then inferred by combining with hospitalization regional data and compared to the number of persons injured by traffic accidents declared by the security force. These hospital information systems successfully report road traffic accidents with 96% sensitivity (95%CI: [92%, 100%]) and 97% specificity (95%CI: [95%, 99%]). The decrease in road traffic accidents observed was significantly less than that observed was significantly lower than that observed in the data from the security force (45% for security force data against 27% for hospital data). Overall, this study shows that hospital information systems are a powerful tool for studying road traffic accidents morbidity in hospital and are complementary to security force data. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Two-year survey of specific hospital wastewater treatment and its impact on pharmaceutical discharges.

    Science.gov (United States)

    Wiest, Laure; Chonova, Teofana; Bergé, Alexandre; Baudot, Robert; Bessueille-Barbier, Frédérique; Ayouni-Derouiche, Linda; Vulliet, Emmanuelle

    2018-04-01

    It is well known that pharmaceuticals are not completely removed by conventional activated sludge wastewater treatment plants. Hospital effluents are of major concern, as they present high concentrations of pharmaceutically active compounds. Despite this, these specific effluents are usually co-treated with domestic wastewaters. Separate treatment has been recommended. However, there is a lack of information concerning the efficiency of separate hospital wastewater treatment by activated sludge, especially on the removal of pharmaceuticals. In this context, this article presents the results of a 2-year monitoring of conventional parameters, surfactants, gadolinium, and 13 pharmaceuticals on the specific study site SIPIBEL. This site allows the characterization of urban and hospital wastewaters and their separate treatment using the same process. Flow proportional sampling, solid-phase extraction, and liquid chromatography coupled with tandem mass spectrometry were used in order to obtain accurate data and limits of quantification consistent with ultra-trace detection. Thanks to these consolidated data, an in-depth characterization of urban and hospital wastewaters was realized, as well as a comparison of treatment efficiency between both effluents. Higher concentrations of organic carbon, AOX, phosphates, gadolinium, paracetamol, ketoprofen, and antibiotics were observed in hospital wastewaters compared to urban wastewaters. Globally higher removals were observed in the hospital wastewater treatment plant, and some parameters were shown to be of high importance regarding removal efficiencies: hydraulic retention time, redox conditions, and ambient temperature. Eleven pharmaceuticals were still quantified at relevant concentrations in hospital and urban wastewaters after treatment (e.g., up to 1 μg/L for sulfamethoxazole). However, as the urban flow was about 37 times higher than the hospital flow, the hospital contribution appeared relatively low compared to

  17. Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

    Science.gov (United States)

    D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

    2013-10-01

    Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

  18. A micro-controller based wide range survey meter

    International Nuclear Information System (INIS)

    Bhingare, R.R.; Bajaj, K.C.; Kannan, S.

    2004-01-01

    Wide range survey meters (1μSv/h -10 Sv/h) with the detector(s) mounted at the end of a two-to-four meter-long extendable tube are widely used for radiation protection survey of difficult to reach locations and high dose rate areas, The commercially available survey meters of this type use two GM counters to cover a wide range of dose rate measurement. A new micro-controller based wide range survey meter using two Si diode detectors has been developed. The use of solid state detectors in the survey meter has a number of advantages like low power consumption, lighter battery powered detector probe, elimination of high voltage for the operation of the detectors, etc. The design uses infrared communication between the probe and the readout unit through a light-weight collapsible extension tube for high reliability. The design details and features are discussed in detail. (author)

  19. Hospitalization Rate and Population-Based Incidence of Hospitalization for Community-Acquired Pneumonia Among Children in Suzhou, China.

    Science.gov (United States)

    Shan, Wei; Shi, Ting; Zhang, Xiyan; Xue, Jian; Wang, Yin; Yu, Jia; Huang, Yukai; Lin, Sheng; Zhao, Genming; Tian, Jianmei; Zhang, Tao

    2018-03-22

    Data on hospitalization burden of CAP in children is very limited in China. This study aimed to estimate the hospitalization rate and population-based incidence of hospitalization of CAP for children <15 years of age in Suzhou, China. This was a retrospective study of children hospitalized in Soochow University Affiliated Children's Hospital (SCH) from January 2010 to December 2014. Children who were residents of downtown Suzhou, 29 days to <15 years of age, with discharge diagnosis codes (ICD-10) including J09 to J18 and J20 to J22 were included. All-cause clinical community-acquired pneumonia (CCAP) and radiographically confirmed pneumonia (RCAP) were identified based on individual medical chart review. The hospitalization rate (HR) and population-based cumulative incidence of hospitalization (HI) were calculated. Among 184,734 children <15 years old admitted to SCH during the study period, 31,302 children were identified as having CCAP, and 24,218 (77.4%) children confirmed as having RCAP. CCAP hospitalization occurred year round and peaked during winter and early spring. The overall HRs for CCAP and RCAP were 189.0 (95%CI, 187.1-190.9) and 146.2 (95%CI, 144-148) per 1,000 hospitalizations respectively, and the HIs per 100,000 children annually were CCAP, 3,235.8 (95%CI, 3207.3-3264.2) and RCAP, 2,503.5 (95%CI, 2,478.3-2,528.6). For children <5 years old, the HR for CCAP was 248.4 (95%CI, 245.9-250.9) and RCAP 194.0 (95%CI, 191.4-196.3) per 1,000 hospitalizations; the HI for CCAP was 6,956.2 (95%CI: 6,892.8-7,019.6) and 5,431.9 (95%CI: 5,375.4-5,488.4) per 100,000 children for RCAP. The highest HR and HI were observed in children 29 days to <6 months old: HR for CCAP was 407.4 (95%CI: 400.9-413.9) per 1,000 hospitalizations and HI for CCAP was 11,203.7 (95%CI: 11,026.8-11,380.6) per 100,000 children annually. There is a considerable burden of CAP among children <15 years of age in Suzhou, particularly among children 29 days to <6 months of age and during winter

  20. Improving Inpatient Surveys: Web-Based Computer Adaptive Testing Accessed via Mobile Phone QR Codes.

    Science.gov (United States)

    Chien, Tsair-Wei; Lin, Weir-Sen

    2016-03-02

    The National Health Service (NHS) 70-item inpatient questionnaire surveys inpatients on their perceptions of their hospitalization experience. However, it imposes more burden on the patient than other similar surveys. The literature shows that computerized adaptive testing (CAT) based on item response theory can help shorten the item length of a questionnaire without compromising its precision. Our aim was to investigate whether CAT can be (1) efficient with item reduction and (2) used with quick response (QR) codes scanned by mobile phones. After downloading the 2008 inpatient survey data from the Picker Institute Europe website and analyzing the difficulties of this 70-item questionnaire, we used an author-made Excel program using the Rasch partial credit model to simulate 1000 patients' true scores followed by a standard normal distribution. The CAT was compared to two other scenarios of answering all items (AAI) and the randomized selection method (RSM), as we investigated item length (efficiency) and measurement accuracy. The author-made Web-based CAT program for gathering patient feedback was effectively accessed from mobile phones by scanning the QR code. We found that the CAT can be more efficient for patients answering questions (ie, fewer items to respond to) than either AAI or RSM without compromising its measurement accuracy. A Web-based CAT inpatient survey accessed by scanning a QR code on a mobile phone was viable for gathering inpatient satisfaction responses. With advances in technology, patients can now be offered alternatives for providing feedback about hospitalization satisfaction. This Web-based CAT is a possible option in health care settings for reducing the number of survey items, as well as offering an innovative QR code access.

  1. Exposure to secondhand smoke at work: a survey of members of the Australian Liquor, Hospitality and Miscellaneous Workers Union.

    Science.gov (United States)

    Cameron, Melissa; Wakefield, Melanie; Trotter, Lisa; Inglis, Graeme

    2003-10-01

    To measure workers' attitudes towards and experiences of exposure to secondhand smoke (SHS) in the workplace. A stratified random sample of members from the Victorian Branch of the Australian Liquor, Hospitality and Miscellaneous Workers Union (LHMU) was interviewed by telephone in September 2001. Of the 1,078 respondents surveyed (77% response rate), hospitality workers comprised 49% of the sample, while the remainder comprised community services, property services and manufacturing workers. Overall, 54% of union members were employed in workplaces that did not completely ban smoking and 34% reported being exposed to SHS during their typical working day. Workplaces with total smoking bans had a high level of compliance with these restrictions, with no workers in these settings indicating exposure to SHS at work. Compared with other workers, hospitality workers reported working in environments that had more permissive smoking policies. Consistent with this, 56% of hospitality workers said they were exposed to SHS during a typical day at work compared with 11% of other workers. Overall, 79% of workers expressed concern about exposure to SHS, including 66% of smokers. Compared with other workers, hospitality workers reported a higher level of concern about exposure to SHS at work. These findings provide evidence that many workers, and especially those employed in the hospitality sector, are exposed to SHS during their working day and are concerned about the effects of such exposure on their health. These findings indicate that workplace smoke-free policies are effective in reducing worker exposure to SHS and demonstrate support for the extension of smoke-free policies to hospitality workplaces.

  2. Impact of 2015 earthquakes on a local hospital in Nepal: A prospective hospital-based study.

    Science.gov (United States)

    Giri, Samita; Risnes, Kari; Uleberg, Oddvar; Rogne, Tormod; Shrestha, Sanu Krishna; Nygaard, Øystein Petter; Koju, Rajendra; Solligård, Erik

    2018-01-01

    Natural disasters pose a great challenge to the health systems and individual health facilities. In low-resource settings, disaster preparedness systems are often limited and not been well described. Two devastating earthquakes hit Nepal within a 17-days period in 2015. This study aims to describe the burden and distribution of emergency cases to a local hospital. This is a prospective observational study of patients presenting to a local hospital for a period of 21 days following the earthquake on April 25, 2015. Demographic and clinical information was prospectively registered for all patients in the systematic emergency registry. Systematic telephone interviews were conducted in a random sample of the patients 90 days after admission to the hospital. A total of 2,003 emergency patients were registered during the period. The average daily number of emergency patients during the first five days was almost five times higher (n = 150) than the pre-incident daily average (n = 35). The majority of injuries were fractures (58%), 348 (56%) in the lower extremities. A total of 345 surgical procedures were performed and the hospital treated 111 patients with severe injuries related to the earthquake (compartment syndrome, crush injury, and internal injury). Among those with follow-up interviews, over 90% reported that they had been severely affected by the earthquakes; complete house damage, living in temporary shelter, or loss of close family member. The hospital experienced a very high caseload during the first days, and the majority of patients needed orthopaedic services. The proportion of severely injured and in-hospital deaths were relatively low, probably indicating that the most severely injured did not reach the hospital in time. The experiences underline the need for robust and easily available local health services that can respond to disasters.

  3. Current nursing practice by hospital-based stoma specialist nurses.

    Science.gov (United States)

    Burch, Jennie

    Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.

  4. Motivational factors influencing nurses to undertake postgraduate hospital-based education.

    Science.gov (United States)

    Kinsella, Danny; Fry, Margaret; Zecchin, Alison

    2018-05-01

    Specialist postgraduate education improves patient health outcomes, and assists in meeting the emerging specialisation of nursing practice. The aim of this study was to investigate the motivational factors that influence nurses' engagement with hospital-based postgraduate education. The research design was descriptive and exploratory, using a survey method. The survey consisted of demographic details, the Participation Reasons Scale (PRS) and open-ended questions. Thirty-four participants (100%) completed the survey. Of the PRS extrinsic and intrinsic factors, Professional Improvement and Development (Factor 1) and Professional Service (Factor 2), both intrinsic factors, ranked the highest. Therefore, this study identified that intrinsic motivation factors influenced engagement with postgraduate specialty programs for early career nurses. These results highlight the importance of intrinsic motivation factors for a nursing workforce and how this can potentially drive behaviour and decision making. A better understanding of motivation factors across a nurse's career could lead to educational strategies that optimise postgraduate program engagement to better support healthcare delivery and a culture of lifelong learning. Copyright © 2018. Published by Elsevier Ltd.

  5. Attitudes of Nurses and Physicians About Clinical Autopsy in Neonatal and Adult Hospital Care: A Survey in Sweden.

    Science.gov (United States)

    Mjörnheim, Berit; Rosendahl, Anders; Eriksson, Lennart C; Takman, Christina

    2015-01-01

    The rate of autopsies has dropped to low levels in Western countries. The aim of this study was to describe the experiences and attitudes of registered nurses (RNs) and physicians (MD) toward clinical autopsies in neonatal and adult hospital care in Sweden. RNs and MDs in neonatal and adult care specialized clinics at a university-affiliated hospital in Sweden were surveyed. Survey responses were tallied, and free-text comments were assessed with qualitative content analysis. Three hundred thirty-six surveys were distributed; the response rate was 35%. Most RNs and 14% of the MDs had limited or no experience participating in an autopsy. Notably, few RNs and approximately one third of the MDs were familiar with the autopsy processes and the treatment of the deceased person's body after an autopsy. More than one third of RNs had experience with talking to relatives regarding autopsy. Most agreed that an autopsy could be supportive for relatives during the grieving process and beneficial for the quality of healthcare. Most MDs (70%) thought that autopsies should be performed more frequently. Qualitative results emphasized that RNs and MDs thought that autopsy information supported the grieving process of relatives-especially parents who had lost a child. The survey data confirm belief in the value of clinical autopsies in neonatal and adult hospital care. RNs and MDs should receive training about the autopsy process and procedures for obtaining consent for an autopsy. RNs are in a position to support the decision making of relatives about providing consent for autopsy and have an opportunity to take a more active role in the autopsy process.

  6. Assessment of hospital-based adult triage at emergency receiving ...

    African Journals Online (AJOL)

    The study was conducted in 6 of the 7 hospitals in the region. ... gency department, the rest receive emergency patients/perform triage from .... gional Referral Hospital (government facility) with emer- ... sionals who were involved in daily initial management of ..... for receiving emergency cases can be complex especially.

  7. Short Communication - Hospital-Based Mortality in Federal Capital ...

    African Journals Online (AJOL)

    Background: Cause-specific mortality data are important to monitor trends in mortality over time. Medical records provide reliable documentation of the causes of deaths occurring in hospitals. This study describes all causes of mortality reported at hospitals in the Federal Capital Territory (FCT) of Nigeria. Methods: Deaths ...

  8. A nationwide population-based cross-sectional survey of health-related quality of life in patients with myeloproliferative neoplasms in Denmark (MPNhealthSurvey: survey design and characteristics of respondents and nonrespondents

    Directory of Open Access Journals (Sweden)

    Brochmann N

    2017-03-01

    Full Text Available Nana Brochmann,1 Esben Meulengracht Flachs,2 Anne Illemann Christensen,3 Christen Lykkegaard Andersen,1 Knud Juel,3 Hans Carl Hasselbalch,1 Ann-Dorthe Zwisler4 1Department of Hematology, Zealand University Hospital, University of Copenhagen, Roskilde, 2Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, 3National Institute of Public Health, University of Southern Denmark, Copenhagen, 4Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark and Odense University Hospital, Odense, Denmark Objective: The Department of Hematology, Zealand University Hospital, Denmark, and the National Institute of Public Health, University of Southern Denmark, created the first nationwide, population-based, and the most comprehensive cross-sectional health-related quality of life (HRQoL survey of patients with myeloproliferative neoplasms (MPNs. In Denmark, all MPN patients are treated in public hospitals and treatments received are free of charge for these patients. Therefore, MPN patients receive the best available treatment to the extent of its suitability for them and if they wish to receive the treatment. The aims of this article are to describe the survey design and the characteristics of respondents and nonrespondents. Material and methods: Individuals with MPN diagnoses registered in the Danish National Patient Register (NPR were invited to participate. The registers of the Danish Civil Registration System and Statistics Denmark provided information regarding demographics. The survey contained 120 questions: validated patient-reported outcome (PRO questionnaires and additional questions addressing lifestyle. Results: A total of 4,704 individuals were registered with MPN diagnoses in the NPR of whom 4,236 were eligible for participation and 2,613 (62% responded. Overall, the respondents covered the broad spectrum of MPN patients, but patients 70–79 years old, living with

  9. Achieving Adherence to Evidence-Based Practices: Are Health IT and Hospital-Physician Integration Complementary or Substitutive Strategies?

    Science.gov (United States)

    Everson, Jordan; Lee, Shoou-Yih Daniel; Adler-Milstein, Julia

    2016-12-01

    In response to evolving policies and conditions, hospitals have increased health information technology (HIT) adoption and strived to improve hospital-physician integration. While evidence suggests that both HIT and integration confer independent benefits, when combined, they may provide complementary means to achieve high performance or overlap to offset each other's contribution. We explore this relationship in the context of hospital adherence to evidence-based practices (EBPs). Using the American Hospital Association's Annual and IT Supplement surveys, and Centers for Medicare and Medicaid Services's Hospital Compare, we estimate the independent relationships and interactions between HIT and hospital-physician integration with respect to EBP adherence. HIT adoption and tight (but not loose) integration are independently associated with greater adherence to EBPs. The interaction between HIT adoption and tight integration is negative, consistent with an offsetting association between HIT adoption and integration in their relationship to EBP adherence. This finding reveals the need to be aware of potential substitutive effects from simultaneous pursuit of multiple approaches to performance improvement. © The Author(s) 2016.

  10. Activity-based costing and its application in a Turkish university hospital.

    Science.gov (United States)

    Yereli, Ayşe Necef

    2009-03-01

    Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. Copyright (c) AORN, Inc, 2009.

  11. A survey of doctors at a UK teaching hospital to assess understanding of recent changes to consent law.

    Science.gov (United States)

    O'Brien, J W; Natarajan, M; Shaikh, I

    2017-06-01

    The UK Supreme Court recently ruled that when consenting patients for treatments or procedures, clinicians must also discuss any associated material risks. We surveyed medical staff at a large UK teaching hospital in order to ascertain knowledge of consent law and current understanding of this change. Email survey sent to medical staff in all specialities at Norfolk and Norwich University Hospital in February 2016. 245 responses (141 Consultants and 104 junior doctors, response rate 32%). 82% consent patients for procedures at least monthly and 23% daily. 31% were not familiar with the concept of material risk. 35% were familiar with the recent change in consent law, 41% were not. 18% were "very uncertain" and 64% "a little uncertain" that their consenting process meets current legal requirements. >92% think that landmark cases and changes in law should be discussed through professional bodies and circulated better locally. The majority were not familiar with the concept of material risk and recent legal changes. A majority were not confident that their practice meets current requirements, suggesting that recent changes in consent law may not be widely understood at this hospital. We suggest more guidance and education may be necessary than is currently available. Increased understanding of recent changes to consent law will reduce the risk taken by NHS trusts and offer patients a service compliant with Supreme Court guidance.

  12. Strategic planning, implementation, and evaluation processes in hospital systems: a survey from Iran.

    Science.gov (United States)

    Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

    2014-09-28

    Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. All the investigated hospitals had a strategic plan. The obtained percentages for the items "the rate of the compliance to requirements" and "the quantity of planning facilitators" (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved.

  13. Hospital-based expert model for health technology procurement planning in hospitals.

    Science.gov (United States)

    Miniati, R; Cecconi, G; Frosini, F; Dori, F; Regolini, J; Iadanza, E; Biffi Gentili, G

    2014-01-01

    Although in the last years technology innovation in healthcare brought big improvements in care level and patient quality of life, hospital complexity and management cost became higher. For this reason, necessity of planning for medical equipment procurement within hospitals is getting more and more important in order to sustainable provide appropriate technology for both routine activity and innovative procedures. In order to support hospital decision makers for technology procurement planning, an expert model was designed as reported in the following paper. It combines the most widely used approaches for technology evaluation by taking into consideration Health Technology Assessment (HTA) and Medical Equipment Replacement Model (MERM). The designing phases include a first definition of prioritization algorithms, then the weighting process through experts' interviews and a final step for the model validation that included both statistical testing and comparison with real decisions. In conclusion, the designed model was able to provide a semi-automated tool that through the use of multidisciplinary information is able to prioritize different requests of technology acquisition in hospitals. Validation outcomes improved the model accuracy and created different "user profiles" according to the specific needs of decision makers.

  14. Advantages and limitations of web-based surveys: evidence from a child mental health survey.

    Science.gov (United States)

    Heiervang, Einar; Goodman, Robert

    2011-01-01

    Web-based surveys may have advantages related to the speed and cost of data collection as well as data quality. However, they may be biased by low and selective participation. We predicted that such biases would distort point-estimates such as average symptom level or prevalence but not patterns of associations with putative risk-factors. A structured psychiatric interview was administered to parents in two successive surveys of child mental health. In 2003, parents were interviewed face-to-face, whereas in 2006 they completed the interview online. In both surveys, interviews were preceded by paper questionnaires covering child and family characteristics. The rate of parents logging onto the web site was comparable to the response rate for face-to-face interviews, but the rate of full response (completing all sections of the interview) was much lower for web-based interviews. Full response was less frequent for non-traditional families, immigrant parents, and less educated parents. Participation bias affected point estimates of psychopathology but had little effect on associations with putative risk factors. The time and cost of full web-based interviews was only a quarter of that for face-to-face interviews. Web-based surveys may be performed faster and at lower cost than more traditional approaches with personal interviews. Selective participation seems a particular threat to point estimates of psychopathology, while patterns of associations are more robust.

  15. 76 FR 39006 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program; Correction

    Science.gov (United States)

    2011-07-05

    ... and 480 [CMS-3239-CN] RIN 0938-AQ55 Medicare Program; Hospital Inpatient Value-Based Purchasing... Value-Based Purchasing Program.'' DATES: Effective Date: These corrections are effective on July 1, 2011... for the hospital value-based purchasing program. Therefore, in section III. 6. and 7. of this notice...

  16. 78 FR 10579 - TRICARE Revision to CHAMPUS DRG-Based Payment System, Pricing of Hospital Claims

    Science.gov (United States)

    2013-02-14

    ... 0720-AB58 TRICARE Revision to CHAMPUS DRG-Based Payment System, Pricing of Hospital Claims AGENCY... change TRICARE's current regulatory provision for hospital claims priced under the DRG-based payment... under the DRG- based payment system from the beneficiary's date of admission, to pricing such claims...

  17. Safety culture in the maternity unit of hospitals in Ilam province, Iran: a census survey using HSOPSC tool.

    Science.gov (United States)

    Akbari, Nahid; Malek, Marzieh; Ebrahimi, Parvin; Haghani, Hamid; Aazami, Sanaz

    2017-01-01

    Improving quality of maternal care as well as patients' safety are two important issues in health-care service. Therefore, this study aimed to assess the culture of patient safety at maternity units. This cross-sectional study was conducted among staffs working at maternity units in seven hospitals of Ilam city, Iran. The staffs included in this study were gynecologists and midwifes working in different positions including matron, supervisors, head of departments and staffs. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC). This study indicated that 59.1% of participants reported fair level of overall perceptions of safety and 67.1% declared that no event was reported during the past 12 months. The most positively perceived dimension of safety culture was teamwork within departments in view of managers (79.41) and personnel (81.10). However, the least positively perceived dimensions of safety culture was staffing levels. The current study revealed areas of strength (teamwork within departments) and weakness (staffing, punitive responses to error) among managers and personnel. In addition, we found that staffs in Ilam's hospitals accept the patient safety culture in maternity units, but, still are far away from excellent culture of patient safety. Therefore, it is necessary to promote culture of patient's safety among professions working in the maternity units of Ilam's hospitals.

  18. Factors related to burnout among Chinese female hospital nurses: cross-sectional survey in Liaoning Province of China.

    Science.gov (United States)

    Wu, Hui; Liu, Li; Sun, Wei; Zhao, Xue; Wang, Jiana; Wang, Lie

    2014-07-01

    To explore the factors associated with burnout among female hospital nurses in China. Burnout has been a major concern in the field of occupational health, and yet there has been little research exploring the factors related to burnout among Chinese nurses. Exploring the factors associated with burnout is important in improving nurses' health and the quality of health care services in China. The study population consisted of 1845 female hospital nurses in the Liaoning Province of China. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey; occupational stress was measured using the Chinese versions of the Job Content Questionnaire and Effort-Reward Imbalance Questionnaire. A general linear regression model was applied to analyse the factors associated with burnout. Mean scores (±SD) were 11.74 (7.14) for emotional exhaustion, 7.12 (5.67) for cynicism and 23.34 (9.60) for self-efficacy. Strong extrinsic effort was the most powerful predictor of emotional exhaustion and cynicism; strong psychological job demands were the most robust predictor of low self-efficacy. The findings suggest that occupational stress was strongly related to burnout among female hospital nurses in China. Occupational stress was identified as the most robust predictor of burnout among Chinese female hospital nurses. Reducing burnout among nurses working in China may require health education, health promotion and occupational training programmes aimed at improving work situations and reducing occupational stress. © 2012 John Wiley & Sons Ltd.

  19. Quality of human-computer interaction - results of a national usability survey of hospital-IT in Germany

    Directory of Open Access Journals (Sweden)

    Bundschuh Bettina B

    2011-11-01

    Full Text Available Abstract Background Due to the increasing functionality of medical information systems, it is hard to imagine day to day work in hospitals without IT support. Therefore, the design of dialogues between humans and information systems is one of the most important issues to be addressed in health care. This survey presents an analysis of the current quality level of human-computer interaction of healthcare-IT in German hospitals, focused on the users' point of view. Methods To evaluate the usability of clinical-IT according to the design principles of EN ISO 9241-10 the IsoMetrics Inventory, an assessment tool, was used. The focus of this paper has been put on suitability for task, training effort and conformity with user expectations, differentiated by information systems. Effectiveness has been evaluated with the focus on interoperability and functionality of different IT systems. Results 4521 persons from 371 hospitals visited the start page of the study, while 1003 persons from 158 hospitals completed the questionnaire. The results show relevant variations between different information systems. Conclusions Specialised information systems with defined functionality received better assessments than clinical information systems in general. This could be attributed to the improved customisation of these specialised systems for specific working environments. The results can be used as reference data for evaluation and benchmarking of human computer engineering in clinical health IT context for future studies.

  20. Patient dose surveys for radiological examinations in Dutch hospitals between 1993 and 2000

    International Nuclear Information System (INIS)

    Spoelstra, F.M.; Geleijns, J.; Broerse, J.J.; Teeuwisse, W.M.; Zweers, D.

    2001-01-01

    Our inventory studies on radiation dose to patients in Dutch hospitals are reviewed and compared with current European guidelines on patient dose and reference dose values of the NRPB. Between the years 1993 and 2000 doses were measured and effective dose was assessed at 14 hospitals for paediatric radiography, at 18 hospitals for PA chest radiography, at 10 respectively 9 hospitals for barium meal and barium enema examinations and at 18 hospitals for CT scans of the brain, chest (including high resolution CT of the chest), abdomen and lumbar spine in The Netherlands. Effective doses varied from 1 μSv (AP chest radiograph premature) to 26 mSv (CT abdomen scan). Doses were in general well below the reference dose values, with the exception of CT where the dose length product often exceeded reference levels. Interhospital variations were considerable, the largest range was observed for PA chest examinations, i.e.a ratio of 27 between maximum and minimum effective dose. (author)

  1. Admission of foreign citizens to the general teaching hospital of Bologna, northeastern Italy: an epidemiological and clinical survey.

    Science.gov (United States)

    Sabbatani, Sergio; Baldi, Elena; Manfredi, Roberto; Chiodo, Francesco

    2006-04-01

    The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy), all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG) features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%), including 2,542 males (34.8%) and 4,769 females (65.2%). Males had a mean age of 36.8+/-14.7 years, while females were aged 30.8+/-12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively) from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8%) were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%), and pregnancy complications (18.7%), followed by psycho-social disturbances (5.9%), malignancies (5.1%), gastrointestinal diseases (4.7%), and voluntary pregnancy interruption (4.4%). Among men, the most frequent causes of admissions were related to trauma (15.9%), followed by gastroenteric disorders (12%), heart-vascular diseases (8.9%), psycho-social disorders (8.4%), respiratory (7.1%), kidney (6.1%), liver (5.2%), and metabolic (4

  2. Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: An epidemiological and clinical survey

    Directory of Open Access Journals (Sweden)

    Sergio Sabbatani

    Full Text Available BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy, all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%, including 2,542 males (34.8% and 4,769 females (65.2%. Males had a mean age of 36.8±14.7 years, while females were aged 30.8±12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8% were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%, and pregnancy complications (18.7%, followed by psycho-social disturbances (5.9%, malignancies (5.1%, gastrointestinal diseases (4.7%, and voluntary pregnancy interruption (4.4%. Among men, the most frequent causes of admissions were related to trauma (15.9%, followed by gastroenteric disorders (12%, heart-vascular diseases (8.9%, psycho-social disorders (8.4%, respiratory (7.1%, kidney (6.1%, liver

  3. Web-based computer adaptive assessment of individual perceptions of job satisfaction for hospital workplace employees.

    Science.gov (United States)

    Chien, Tsair-Wei; Lai, Wen-Pin; Lu, Chih-Wei; Wang, Weng-Chung; Chen, Shih-Chung; Wang, Hsien-Yi; Su, Shih-Bin

    2011-04-17

    To develop a web-based computer adaptive testing (CAT) application for efficiently collecting data regarding workers' perceptions of job satisfaction, we examined whether a 37-item Job Content Questionnaire (JCQ-37) could evaluate the job satisfaction of individual employees as a single construct. The JCQ-37 makes data collection via CAT on the internet easy, viable and fast. A Rasch rating scale model was applied to analyze data from 300 randomly selected hospital employees who participated in job-satisfaction surveys in 2008 and 2009 via non-adaptive and computer-adaptive testing, respectively. Of the 37 items on the questionnaire, 24 items fit the model fairly well. Person-separation reliability for the 2008 surveys was 0.88. Measures from both years and item-8 job satisfaction for groups were successfully evaluated through item-by-item analyses by using t-test. Workers aged 26 - 35 felt that job satisfaction was significantly worse in 2009 than in 2008. A Web-CAT developed in the present paper was shown to be more efficient than traditional computer-based or pen-and-paper assessments at collecting data regarding workers' perceptions of job content.

  4. Web-based computer adaptive assessment of individual perceptions of job satisfaction for hospital workplace employees

    Directory of Open Access Journals (Sweden)

    Chen Shih-Chung

    2011-04-01

    Full Text Available Abstract Background To develop a web-based computer adaptive testing (CAT application for efficiently collecting data regarding workers' perceptions of job satisfaction, we examined whether a 37-item Job Content Questionnaire (JCQ-37 could evaluate the job satisfaction of individual employees as a single construct. Methods The JCQ-37 makes data collection via CAT on the internet easy, viable and fast. A Rasch rating scale model was applied to analyze data from 300 randomly selected hospital employees who participated in job-satisfaction surveys in 2008 and 2009 via non-adaptive and computer-adaptive testing, respectively. Results Of the 37 items on the questionnaire, 24 items fit the model fairly well. Person-separation reliability for the 2008 surveys was 0.88. Measures from both years and item-8 job satisfaction for groups were successfully evaluated through item-by-item analyses by using t-test. Workers aged 26 - 35 felt that job satisfaction was significantly worse in 2009 than in 2008. Conclusions A Web-CAT developed in the present paper was shown to be more efficient than traditional computer-based or pen-and-paper assessments at collecting data regarding workers' perceptions of job content.

  5. A simulation model of hospital management based on cost accounting analysis according to disease.

    Science.gov (United States)

    Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki

    2004-12-01

    Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.

  6. Hospital-Based Acute Care After Total Hip and Knee Arthroplasty: Implications for Quality Measurement.

    Science.gov (United States)

    Trimba, Roman; Laughlin, Richard T; Krishnamurthy, Anil; Ross, Joseph S; Fox, Justin P

    2016-03-01

    Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Tutorial on technology transfer and survey design and data collection for measuring Internet and Intranet existence, usage, and impact (survey-2000) in acute care hospitals in the United States.

    Science.gov (United States)

    Hatcher, M

    2001-02-01

    This paper provides a tutorial of technology transfer for management information systems in health care. Additionally it describes the process for a national survey of acute care hospitals using a random sample of 813 hospitals. The purpose of the survey was to measure the levels of Internet and Intranet existence and usage in acute care hospitals. The depth of the survey includes e-commerce for both business to business and with customers. The relationships with systems approaches, user involvement, user satisfaction and decision-making will be studied. Changes with results of a prior survey conducted in 1997 can be studied and enabling and inhabiting factors identified. This information will provide benchmarks for hospitals to plan their network technology position and to set goals.

  8. Is There a Relationship Between Value-Based Purchasing and Hospital Profitability? An Exploratory Study of Missouri Hospitals.

    Science.gov (United States)

    Turner, Jason S; Broom, Kevin D; Counte, Michael A

    2015-01-01

    Recent US legislation is attempting to transition inpatient Medicare payments to a value-based purchasing (VBP) program. The VBP program is a pay-for-performance (P4P) system that incentivizes hospitals to improve patient satisfaction, health outcomes, and adherence to clinical protocols while simultaneously holding down costs. Our study evaluates (1) the impact of financial performance on the VBP adjustments and (2) whether there is a correlation between the VBP adjustment and the financial performance of Missouri hospitals that opted into the program. While upward and downward adjustments to the inpatient base rate may be related to hospital financial performance, prior financial performance may also be related to the adjustments. Financial health may allow facilities to invest and position the hospital for favorable future P4P adjustments. The results of our analysis indicate the VBP adjustment to the inpatient base rate is very small (±0.18%), clustered around zero, and is not correlated with financial performance. We also find that financial performance and improvement in the years prior to the adjustment are not related to the VBP adjustment or its respective components. This suggests that CMS is avoiding penalizing less profitable facilities, but the adjustment is also so small and tightly clustered around zero that it is failing to provide an adequate incentive to hospitals. The costs of improving patient satisfaction, clinical process adherence, health care outcomes, and efficiency above that of peers coupled with the growing number of metrics being used to calculate the VBP adjustments call into question the financial incentives of the hospital VBP program.

  9. Variations in renal morphometry: A hospital-based Indian study

    Directory of Open Access Journals (Sweden)

    Ranjeet S Rathore

    2016-01-01

    Conclusions: Our study revealed that there exist differences in various morphometric parameters of the kidney and ureter in different subsets of the Indian population attending our hospital as compared with the standard values quoted in the world literature.

  10. High prevalence of hospital-acquired infections caused by gram-negative carbapenem resistant strains in Vietnamese pediatric ICUs: A multi-centre point prevalence survey

    NARCIS (Netherlands)

    Le, N.K.; Wertheim, H.F.L.; Vu, P.D.; Khu, D.T.; Le, H.T.; Hoang, B.T.; Vo, V.T.; Lam, Y.M.; Vu, D.T.; Nguyen, Thanh Son; Thai, T.Q.; Nilsson, L.E.; Rydell, U.; Nguyen, K.V.; Nadjm, B.; Clarkson, L.; Hanberger, H.; Larsson, M.

    2016-01-01

    There is scarce information regarding hospital-acquired infections (HAIs) among children in resource-constrained settings. This study aims to measure prevalence of HAIs in Vietnamese pediatric hospitals.Monthly point prevalence surveys (PPSs) in 6 pediatric intensive care units (ICUs) in 3 referral

  11. Postulating a dermal pathway for exposure to anti-neoplastic drugs among hospital workers. Applying a conceptual model to the results of three workplace surveys

    NARCIS (Netherlands)

    Kromhout, H.; Hoek, F.; Uitterhoeve, R.; Huijbers, R.; Overmars, R.F.; Anzion, R.; Vermeulen, R.

    2000-01-01

    Dermal exposure to anti-neoplastic drugs has been suggested as a potentially important route of exposure of hospital workers. Three small-scale workplace surveys were carried out in several hospitals focusing on contamination by leakage from IV infusion systems; contamination by spilled urine of

  12. Ranking Hospitals Based on Colon Surgery and Abdominal Hysterectomy Surgical Site Infection Outcomes: Impact of Limiting Surveillance to the Operative Hospital.

    Science.gov (United States)

    Yokoe, Deborah S; Avery, Taliser R; Platt, Richard; Kleinman, Ken; Huang, Susan S

    2018-03-16

    Hospital-specific surgical site infection (SSI) performance following colon surgery and abdominal hysterectomies can impact hospitals' relative rankings around quality metrics used to determine financial penalties. Current SSI surveillance largely focuses on SSI detected at the operative hospital. Retrospective cohort study to assess the impact on hospitals' relative SSI performance rankings when SSI detected at non-operative hospitals are included. We utilized data from a California statewide hospital registry to assess for evidence of SSI following colon surgery or abdominal hysterectomies performed 3/1/2011-11/30/2013 using previously validated claims-based SSI surveillance methods. Risk-adjusted hospital-specific rankings based on SSI detected at operative hospitals versus any California hospital were generated. Among 60,059 colon surgeries at 285 hospitals and 64,918 abdominal hysterectomies at 270 hospitals, 5,921 (9.9%) colon surgeries and 1,481 (2.3%) abdominal hysterectomies received a diagnosis code for SSI within the 30 days following surgery. 7.2% of colon surgery and 13.4% of abdominal hysterectomy SSI would have been missed by operative hospital surveillance alone. The proportion of individual hospital's SSI detected during hospitalizations at other hospitals varied widely. Including non-operative hospital SSI resulted in improved relative ranking of 11 (3.9%) colon surgery and 13 (4.8%) hysterectomy hospitals so that they were no longer in the worst performing quartile, mainly among hospitals with relatively high surgical volumes. Standard SSI surveillance that mainly focuses on infections detected at the operative hospital causes varying degrees of SSI under-estimation, leading to inaccurate assignment or avoidance of financial penalties for approximately one in eleven to sixteen hospitals.

  13. Antimicrobial usage in German acute care hospitals: results of the third national point prevalence survey and comparison with previous national point prevalence surveys.

    Science.gov (United States)

    Aghdassi, Seven Johannes Sam; Gastmeier, Petra; Piening, Brar Christian; Behnke, Michael; Peña Diaz, Luis Alberto; Gropmann, Alexander; Rosenbusch, Marie-Luise; Kramer, Tobias Siegfried; Hansen, Sonja

    2018-04-01

    Previous point prevalence surveys (PPSs) revealed the potential for improving antimicrobial usage (AU) in German acute care hospitals. Data from the 2016 German national PPS on healthcare-associated infections and AU were used to evaluate efforts in antimicrobial stewardship (AMS). A national PPS in Germany was organized by the German National Reference Centre for Surveillance of Nosocomial Infections in 2016 as part of the European PPS initiated by the ECDC. The data were collected in May and June 2016. Results were compared with data from the PPS 2011. A total of 218 hospitals with 64 412 observed patients participated in the PPS 2016. The prevalence of patients with AU was 25.9% (95% CI 25.6%-26.3%). No significant increase or decrease in AU prevalence was revealed in the group of all participating hospitals. Prolonged surgical prophylaxis was found to be common (56.1% of all surgical prophylaxes on the prevalence day), but significantly less prevalent than in 2011 (P < 0.01). The most frequently administered antimicrobial groups were penicillins plus β-lactamase inhibitors (BLIs) (23.2%), second-generation cephalosporins (12.9%) and fluoroquinolones (11.3%). Significantly more penicillins plus BLIs and fewer second-generation cephalosporins and fluoroquinolones were used in 2016. Overall, an increase in the consumption of broad-spectrum antimicrobials was noted. For 68.7% of all administered antimicrobials, the indication was documented in the patient notes. The current data reaffirm the points of improvement that previous data identified and reveal that recent efforts in AMS in German hospitals require further intensification.

  14. Characteristics of Antimicrobial Stewardship Programs at Veterans Affairs Hospitals: Results of a Nationwide Survey.

    Science.gov (United States)

    Chou, Ann F; Graber, Christopher J; Jones, Makoto; Zhang, Yue; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew; Kelly, Allison; Glassman, Peter A

    2016-06-01

    BACKGROUND Antimicrobial stewardship programs (ASPs) are variably implemented. OBJECTIVE To characterize variations of antimicrobial stewardship structure and practices across all inpatient Veterans Affairs facilities in 2012 and correlate key characteristics with antimicrobial usage. DESIGN A web-based survey regarding stewardship activities was administered to each facility's designated contact. Bivariate associations between facility characteristics and inpatient antimicrobial use during 2012 were determined. SETTING Total of 130 Veterans Affairs facilities with inpatient services. RESULTS Of 130 responding facilities, 29 (22%) had a formal policy establishing an ASP, and 12 (9%) had an approved ASP business plan. Antimicrobial stewardship teams were present in 49 facilities (38%); 34 teams included a clinical pharmacist with formal infectious diseases (ID) training. Stewardship activities varied across facilities, including development of yearly antibiograms (122 [94%]), formulary restrictions (120 [92%]), stop orders for antimicrobial duration (98 [75%]), and written clinical pathways for specific conditions (96 [74%]). Decreased antimicrobial usage was associated with having at least 1 full-time ID physician (P=.03), an ID fellowship program (P=.003), and a clinical pharmacist with formal ID training (P=.006) as well as frequency of systematic patient-level reviews of antimicrobial use (P=.01) and having a policy to address antimicrobial use in the context of Clostridium difficile infection (P=.01). Stop orders for antimicrobial duration were associated with increased use (P=.03). CONCLUSIONS ASP-related activities varied considerably. Decreased antibiotic use appeared related to ID presence and certain select practices. Further statistical assessments may help optimize antimicrobial practices. Infect Control Hosp Epidemiol 2016;37:647-654.

  15. [Cost of hospitalization by the Activity Based Costing method in the neonatal department of Principal Hospital of Dakar].

    Science.gov (United States)

    Tchamdja, T; Balaka, A; Tchandana, M; Agbétra, A

    2015-01-01

    To determine the cost of hospitalization per day in the neonatal department of Principal Hospital of Dakar. This prospective study took place during the month of July 2011 in the newborn unit. The activity-based costing method was used to analyze costs. During the study period, 52 newborns were hospitalized for a total of 590 days. The cost of the human resources during that month was 9,907,832 FCFA (US $ 19,815.66), the cost of depreciation of fixed assets was estimated at 571,952 FCFA (US $ 1143.90), and supplies at 112,084 FCFA (US $ 224.17). External services cost 386,753 FCFA (US $ 773.51) and support services 6,917,380.65 FCFA (US $ 13,834.7613). The monthly expenses incurred for the hospitalization of newborns totaled 17,896,002 FCFA (US $ 35,792), for a cost per patient per day of 30,332.20 FCFA (US $ 60.66) and an average cost of hospitalization 334,153.88 FCFA (US $ 668,31). This study is the first of its kind in Senegal and neighboring countries. By applying the ABC approach, we can obtain a more detailed and precise estimate of the cost of activities and services. Process improvements and corrective actions should make it possible to identify cost drivers, such as time.

  16. Survey of WBSNs for Pre-Hospital Assistance: Trends to Maximize the Network Lifetime and Video Transmission Techniques

    Directory of Open Access Journals (Sweden)

    Enrique Gonzalez

    2015-05-01

    Full Text Available This survey aims to encourage the multidisciplinary communities to join forces for innovation in the mobile health monitoring area. Specifically, multidisciplinary innovations in medical emergency scenarios can have a significant impact on the effectiveness and quality of the procedures and practices in the delivery of medical care. Wireless body sensor networks (WBSNs are a promising technology capable of improving the existing practices in condition assessment and care delivery for a patient in a medical emergency. This technology can also facilitate the early interventions of a specialist physician during the pre-hospital period. WBSNs make possible these early interventions by establishing remote communication links with video/audio support and by providing medical information such as vital signs, electrocardiograms, etc. in real time. This survey focuses on relevant issues needed to understand how to setup a WBSN for medical emergencies. These issues are: monitoring vital signs and video transmission, energy efficient protocols, scheduling, optimization and energy consumption on a WBSN.

  17. Survey of WBSNs for Pre-Hospital Assistance: Trends to Maximize the Network Lifetime and Video Transmission Techniques

    Science.gov (United States)

    Gonzalez, Enrique; Peña, Raul; Vargas-Rosales, Cesar; Avila, Alfonso; Perez-Diaz de Cerio, David

    2015-01-01

    This survey aims to encourage the multidisciplinary communities to join forces for innovation in the mobile health monitoring area. Specifically, multidisciplinary innovations in medical emergency scenarios can have a significant impact on the effectiveness and quality of the procedures and practices in the delivery of medical care. Wireless body sensor networks (WBSNs) are a promising technology capable of improving the existing practices in condition assessment and care delivery for a patient in a medical emergency. This technology can also facilitate the early interventions of a specialist physician during the pre-hospital period. WBSNs make possible these early interventions by establishing remote communication links with video/audio support and by providing medical information such as vital signs, electrocardiograms, etc. in real time. This survey focuses on relevant issues needed to understand how to setup a WBSN for medical emergencies. These issues are: monitoring vital signs and video transmission, energy efficient protocols, scheduling, optimization and energy consumption on a WBSN. PMID:26007741

  18. A survey of nine years heart transplantation at Erasme Hospital, University of Brussels.

    Science.gov (United States)

    Primo, G; Le Clerc, J L; Antoine, M; De Smet, J M; Joris, M

    1991-01-01

    Between March 1982 and March 1991, 225 heart transplantations (HTx) have been performed in 220 patients suffering end stage cardiac disease. Thirteen percent were females and 87% were males. Age range was from 5 to 68 years. The underlying cardiac disease was ischemic cardiopathy in 51.5%, congestive dilated cardiomyopathy in 42%, valvular cardiomyopathy in 3.5%, toxic myocarditis (post-adriamycin) in 1.5% and chronic rejection in 2.5% (retransplantation). Selection of the recipients was done following the currently well established criteria also taking into account the absolute major contraindications for HTx. Due to the still increasing demand of donor organs, currently donor age has been extended up to 50 years for male and 55 years for female donors. One quarter of the grafts were harvested on site in our institution, two other quarters were harvested somewhere else in Belgium and the last quarter provided by other countries cooperating with Eurotransplant. All patients have undergone orthotopic cardiac transplantation using the standard Lower and Shumway technique. Immunosuppression protocols have changed four times throughout the years. Nevertheless all were based on the use of Ciclosporine variously combined with other current immunosuppressive drugs. Rejection monitoring relied on routine endocardiac biopsy and was diagnosed according to the Billingham criteria. The in-hospital mortality is currently 11%. Infection, early right heart graft failure and acute rejection were the leading causes of death. The major causes of early morbidity were several curable infections, reversible rejection episodes, transient acute renal failure and controllable arterial hypertension. Among the survivors followed for at least one month up to nine years, half of late mortality was caused by chronic rejection followed by infection, sudden death, metabolic disorders, stroke and malignancy. Late morbidity involves cases of mild coronary graft diseases, biological renal

  19. A brief survey on problems and countermeasures of electronic medical record system in basic hospitals

    OpenAIRE

    You-bo JIA; Nan LI

    2014-01-01

    The paper, which took Yanggu People’s hospital’s EPR system in the information construction as a case,analyzed domestic EPR system’s current situation, summarized the problems of the EPR system in its implementation process, and some changes to our hospitals it brought.

  20. Attitudes of hospitalized patients toward wearing patient clothing in Tianjin, China: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Lu Liu

    2016-12-01

    Conclusions: More than half of the hospitalized patients dislike wearing patient clothing because they were unaware of its functions and were skeptical about its hygiene, comfortability, fit, and appearance. Therefore, these patients must be provided with comfortable, well fitting, hygienic, and aesthetically pleasing clothing.

  1. Survey of safety practices among hospital laboratories in Oromia Regional State, Ethiopia.

    Science.gov (United States)

    Sewunet, Tsegaye; Kebede, Wakjira; Wondafrash, Beyene; Workalemau, Bereket; Abebe, Gemeda

    2014-10-01

    Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia. Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software. All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards. Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.

  2. Quantifying culture gaps between physicians and managers in Dutch hospitals: A survey

    NARCIS (Netherlands)

    Klopper-Kes, A.H.J.; Siesling, Sabine; Meerdink, Nienke; Wilderom, Celeste P.M.; van Harten, Willem H.

    2010-01-01

    Background: The demands in hospitals for safety and quality, combined with limitations in financing health care require effective cooperation between physicians and managers. The complex relationship between both groups has been described in literature. We aim to add a perspective to literature, by

  3. Occupational injury history and universal precautions awareness: a survey in Kabul hospital staff

    Directory of Open Access Journals (Sweden)

    Garner Paul

    2010-01-01

    Full Text Available Abstract Background Health staff in Afghanistan may be at high risk of needle stick injury and occupational infection with blood borne pathogens, but we have not found any published or unpublished data. Methods Our aim was to measure the percentage of healthcare staff reporting sharps injuries in the preceding 12 months, and to explore what they knew about universal precautions. In five randomly selected government hospitals in Kabul a total of 950 staff participated in the study. Data were analyzed with Epi Info 3. Results Seventy three percent of staff (72.6%, 491/676 reported sharps injury in the preceding 12 months, with remarkably similar levels between hospitals and staff cadres in the 676 (71.1% people responding. Most at risk were gynaecologist/obstetricians (96.1% followed by surgeons (91.1%, nurses (80.2%, dentists (75.4%, midwives (62.0%, technicians (50.0%, and internist/paediatricians (47.5%. Of the injuries reported, the commonest were from hollow-bore needles (46.3%, n = 361/780, usually during recapping. Almost a quarter (27.9% of respondents had not been vaccinated against hepatitis B. Basic knowledge about universal precautions were found insufficient across all hospitals and cadres. Conclusion Occupational health policies for universal precautions need to be implemented in Afghani hospitals. Staff vaccination against hepatitis B is recommended.

  4. Dry eye disease: prevalence, distribution and determinants in a hospital-based population.

    Science.gov (United States)

    Onwubiko, Stella N; Eze, Boniface I; Udeh, Nnemma N; Arinze, Obinna C; Onwasigwe, Ernest N; Umeh, Rich E

    2014-06-01

    To determine the prevalence, distribution and risk factors for dry eye disease (DED) in a tertiary ophthalmic outpatient population. The study was a cross-sectional descriptive hospital-based survey conducted at the Eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between September and December, 2011. The participants comprised adult ophthalmic outpatients aged 18 years or older. Participants' sociodemographic data were obtained. Dry eye disease was assessed subjectively with the Ocular Surface Disease Index (OSDI) questionnaire; and objectively with Schirmer's test and Tear-film Break-up Time (TBUT). An OSDI score of ≥ 50 with a TBUT of 40 years (OR 1.88, 95% CI 1.06-3.35, p=0.0004), non-possession of formal education (OR 0.40, 95% CI 0.21-0.74, p=0.001) but not gender (OR 1.48, 95% CI 0.89-2.46, p=0.158). The prevalence of DED among ophthalmic outpatients at UNTH, Enugu, is comparatively high. Older age and illiteracy are predictors of DED. There is need for high index of diagnostic suspicion to prevent sight-threatening complications of DED. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  5. Telehealth coordinators in hospital based telehealth services: Who are they and what do they do?

    Science.gov (United States)

    Edirippulige, Sisira; Armfield, Nigel R; Greenup, Phil; Bryett, Andrew

    2016-12-01

    Many studies have identified the importance of 'telehealth coordinators' for successful telehealth implementation and operation. However, little is known about the telehealth coordinators' functions, the skills and competencies required and the reasons for their influence. This study aimed to examine the key functions of telehealth coordinators in the Queensland public health system, their perceptions about their role, and the level of competencies to support this role. All telehealth coordinators within Queensland Health Telehealth Services were invited to complete a questionnaire. We collected: (i) demographic information; (ii) details of their telehealth work; and (iii) information about knowledge and skills relevant to their telehealth coordinator role. Eighteen of 20 (90%) participants completed and submitted the survey. Telehealth coordinators were responsible for a range of tasks relating to telehealth consultations, technical assistance, administration, research, promotion and marketing. Nearly all telehealth coordinators (n = 17, 94%) were confident in carrying out the tasks of their job. The majority of telehealth coordinators (n = 13, 72%) thought education and training relating to telehealth would help improve their job. The top three topics that telehealth coordinators were keen to learn about were: (i) examples of clinical use of telehealth; (ii) types of technologies used; and (iii) telehealth clinical and business models. Our participants were all hospital-based; as the use of telehealth is growing outside of the traditional hospital settings, the role of telehealth coordinators is likely to change. © The Author(s) 2016.

  6. An inter-hospital comparison of patient dose based on clinical indications

    International Nuclear Information System (INIS)

    Teeuwisse, W.; Geleijns, J.; Veldkamp, W.

    2007-01-01

    Patient dose is usually estimated for a single radiographic projection or computed tomography (CT) series. In this study, patient dose was calculated for predefined clinical indications (24 radiography, 11 CT). Members of the radiology staff of each of 11 hospitals were trained in dose measurement and calculation techniques. Based on clinical indications participants decided on imaging protocols and calculated cumulative effective dose for a complete examination. Effective dose ranged from <1 μSv to 0.6 mSv for examinations with radiographs and from 0.2 to 12 mSv for CT scans. Differences in the imaging protocols contributedd to a substantial variation in patient dose. For mammography, average glandular dose (AGD) was estimated for 32-, 53- and 90-mm compressed breast thicknesses, with a median value of 0.74, 1.74 and 3.40 mGy, respectively. The results presented here demonstrate that a pragmatic choice of dosimetry methods enables local staff to estimate effective dose. The inclusion of imaging protocols in the dose surveys provided a broader view on the variations in patient dose between hospitals. (orig.)

  7. The role of hospital payments in the adoption of new medical technologies: an international survey of current practice.

    Science.gov (United States)

    Sorenson, Corinna; Drummond, Michael; Torbica, Aleksandra; Callea, Giuditta; Mateus, Ceu

    2015-04-01

    This study examined the role of prospective payment systems in the adoption of new medical technologies across different countries. A literature review was conducted to provide background for the study and guide development of a survey instrument. The survey was disseminated to hospital payment systems experts in 15 jurisdictions. Fifty-one surveys were disseminated, with 34 returned. The surveys returned covered 14 of the 15 jurisdictions invited to participate. The majority (71%) of countries update the patient classification system and/or payment tariffs on an annual basis to try to account for new technologies. Use of short-term separate or supplementary payments for new technologies occurs in 79% of countries to ensure adequate funding and facilitate adoption. A minority (43%) of countries use evidence of therapeutic benefit and/or costs to determine or update payment tariffs, although it is somewhat more common in establishing short-term payments. The main barrier to using evidence is uncertain or unavailable clinical evidence. Almost three-fourths of respondents believed diagnosis-related group systems incentivize or deter technology adoption, depending on the particular circumstances. Improvements are needed, such as enhanced strategies for evidence generation and linking evidence of value to payments, national and international collaboration and training to improve existing practice, and flexible timelines for short-term payments. Importantly, additional research is needed to understand how different payment policies impact technology uptake as well as quality of care and costs.

  8. Survey of ionizing radiations to workers in Carlos Andrade Hospital during March 1998 and December 2000

    International Nuclear Information System (INIS)

    Del Pino Albuja, Norma Josefina

    2005-01-01

    Ionizing radiation represents a daily risk for the people who work occupationally exposed to radiations at Carlos Andrade Marin hospital. For that reason, the knowledge of the basic concepts of the physical phenomenon of ionizing radiation and the study of dosimetry that is carried out to occupationally exposed workers at Carlos Andrade Marin hospital are very important to manage ionizing radiations as a risk factor. This study shows the system of dosimetry of Carlos Andrade Marin hospital. Moreover, it includes an analysis between the doses received by workers occupationally exposed of Carlos Andrade Marin hospital and the limit dose internationally recommended. For this investigation, it was used bibliographical revision, descriptive, historical, and inductive study, and descriptive statistics with the software Microsoft Office Excel 2003. The hypothesis of this research is that the workplaces exposed to ionizing radiations at Carlos Andrade Marin hospital have an appropriate dosimetry system. Furthermore, it considers superficial and deep doses of occupationally exposed workers of both genders and age. The obtained results of the studied period 1998 to 2000 are: i) The 99% of the occupationally exposed workers used the dosimeter. ii) The higher superficial dose -13,34mSv - corresponds to a Hemodynamic doctor. iii) The higher deep dose -7,1mSv - corresponds to a Nuclear Medicine medical technologist. iv) The higher doses mentioned above are under the limits internationally recommended by the International Commission on International Protection. These limits are 20mSv per year and 100mSv per 5 years respectively. The conclusions of the investigation are: i) Carlos Andrade Marin hospital has an adequate Dosimetry system and the occupationally exposed workers are permanently monitored with the dosimeter. ii) The Nuclear Medicine workers have the higher doses of exposition related to the other areas of Carlos Andrade Marin hospital. iii) The most exposed

  9. Maternal mortality ratio in Lebanon in 2008: a hospital-based reproductive age mortality study (RAMOS).

    Science.gov (United States)

    Hobeika, Elie; Abi Chaker, Samer; Harb, Hilda; Rahbany Saad, Rita; Ammar, Walid; Adib, Salim

    2014-01-01

    International agencies have recently assigned Lebanon to the group H of countries with "no national data on maternal mortality," and estimated a corresponding maternal mortality ratio (MMR) of 150 per 100,000 live births. The Ministry of Public Health addressed the discrepancy perceived between the reality of the maternal mortality ratio experience in Lebanon and the international report by facilitating a hospital-based reproductive age mortality study, sponsored by the World Health Organization Representative Office in Lebanon, aiming at providing an accurate estimate of a maternal mortality ratio for 2008. The survey allowed a detailed analysis of maternal causes of deaths. Reproductive age deaths (15-49 years) were initially identified through hospital records. A trained MD traveled to each hospital to ascertain whether recorded deaths were in fact maternal deaths or not. ICD10 codes were provided by the medical controller for each confirmed maternal deaths. There were 384 RA death cases, of which 13 were confirmed maternal deaths (339%) (numerator). In 2008, there were 84823 live births in Lebanon (denominator). The MMR in Lebanon in 2008 was thus officially estimated at 23/100,000 live births, with an "uncertainty range" from 153 to 30.6. Hemorrhage was the leading cause of death, with double the frequency of all other causes (pregnancy-induced hypertension, eclampsia, infection, and embolism). This specific enquiry responded to a punctual need to correct a clearly inadequate report, and it should be relayed by an on-going valid surveillance system. Results indicate that special attention has to be devoted to the management of peri-partum hemorrhage cases. Arab, postpartum hemorrhage, development, pregnancy management, verbal autopsy

  10. Comparison of Responses on the 1994 Biennial Student Survey by the Consumer and Hospitality Services Division and Overall Students of the Milwaukee Area Technical College.

    Science.gov (United States)

    Advincula-Carpenter, Marietta M.

    To gather curriculum planning information, the Research, Planning and Development Division of Milwaukee Area Technical College (MATC) conducts student surveys biennially. Responses of 579 MATC students enrolled in consumer and hospitality services division (CHSD) programs to the 1994 survey were compared with those of the 5,071 students…

  11. Trends in Extended Spectrum Beta-Lactamase (ESBL) Producing Enterobacteriaceae and ESBL Genes in a Dutch Teaching Hospital, Measured in 5 Yearly Point Prevalence Surveys (2010-2014)

    NARCIS (Netherlands)

    Willemsen, Ina; Oome, Stijn; Verhulst, Carlo; Pettersson, Annika; Verduin, Kees; Kluytmans, Jan

    2015-01-01

    This paper describes the trends in prevalence of ESBL producing Enterobacteriaceae (ESBL-E) and ESBL genes, measured in five consecutive yearly Point Prevalence Surveys (PPS). All patients present in the hospital and in a day-care clinic (including patients on dialysis) on the day of the survey,

  12. Performance Based Supplementary Payment System at University Hospitals in Turkey

    Directory of Open Access Journals (Sweden)

    Vahit YÝÐÝT

    2017-06-01

    Results: The result of the analysis has revealed that PBSP system encourage physicians who would like to receive financial incentives. PBSP system supports the individual performance, reduces waiting times in patients, increases revenues and decreases expenditures and increases in efficiency of department. However, this payment system increases work load, number of examinations and provokes the conflict among personals. Conclusions: University hospitals are academic institutions that perform important missions such as research, medical education and health services provision. Therefore, PBSP system should be revised so as to encourage performing these missions at university hospitals. There is also shortage of financial resources at the university hospitals. This situation leads to less additional payments to physicians. [J Contemp Med 2017; 7(2.000: 126-131

  13. The impact of HMOs on hospital-based uncompensated care.

    Science.gov (United States)

    Thorpe, K E; Seiber, E E; Florence, C S

    2001-06-01

    Managed care in general and HMOs in particular have become the vehicle of choice for controlling health care spending in the private sector. By several accounts, managed care has achieved its cost-containment objectives. At the same time, the percentage of Americans without health insurance coverage continues to rise. For-profit and not-for-profit hospitals have traditionally financed care for the uninsured from profits derived from patients with insurance. Thus the relationship between growth in managed care and HMOs, hospital "profits," and care for the uninsured represent an important policy question. Using national data over an eight-year period, we find that a ten-percentage point increase in managed care penetration is associated with a two-percentage point reduction in hospital total profit margin and a 0.6 percentage point decrease in uncompensated care.

  14. Views From the Pacific--Military Base Hospital Libraries in Hawaii and Guam.

    Science.gov (United States)

    Stephenson, Priscilla L; Trafford, Mabel A; Hadley, Alice E

    2016-01-01

    Hospital libraries serving military bases offer a different perspective on library services. Two libraries located on islands in the Pacific Ocean provide services to active duty service men and women, including those deployed to other regions of the world. In addition, these hospital libraries serve service members' families living on the base, and often citizens from the surrounding communities.

  15. Comparison of Three Methods Estimating Baseline Creatinine For Acute Kidney Injury in Hospitalized Patients: a Multicentre Survey in Third-Level Urban Hospitals of China.

    Science.gov (United States)

    Lang, Xia-Bing; Yang, Yi; Yang, Ju-Rong; Wan, Jian-Xin; Yu, Sheng-Qiang; Cui, Jiong; Tang, Xiao-Jing; Chen, Jianghua

    2018-01-01

    A lack of baseline serum creatinine (SCr) data leads to underestimation of the burden caused by acute kidney injury (AKI) in developing countries. The goal of this study was to investigate the effects of various baseline SCr analysis methods on the current diagnosis of AKI in hospitalized patients. Patients with at least one SCr value during their hospital stay between January 1, 2011 and December 31, 2012 were retrospectively included in the study. The baseline SCr was determined either by the minimum SCr (SCrMIN) or the estimated SCr using the MDRD formula (SCrGFR-75). We also used the dynamic baseline SCr (SCrdynamic) in accordance with the 7 day/48 hour time window. AKI was defined based on the KDIGO SCr criteria. Of 562,733 hospitalized patients, 350,458 (62.3%) had at least one SCr determination, and 146,185 (26.0%) had repeat SCr tests. AKI was diagnosed in 13,883 (2.5%) patients using the SCrMIN, 21,281 (3.8%) using the SCrGFR-75 and 9,288 (1.7%) using the SCrdynamic. Compared with the non-AKI patients,